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  • Title: Chronic idiopathic thrombocytopenic purpura (ITP) in adult Ethiopians: clinical findings and response to therapy.
    Author: Shamebo M, Johnson O.
    Journal: Ethiop Med J; 1991 Apr; 29(2):71-80. PubMed ID: 2060509.
    Abstract:
    Between January 1982 and December 1989, thirty four cases of chronic idiopathic thrombocytopenic purpura (ITP) were seen in adult Ethiopians in the Department of Internal Medicine in-patient and haematology referral clinic, of Tikur Anbessa teaching hospital. Twenty three were females and eleven males; female to male ratio of 2.1:1. The age range was 13-57 years, with a mean of 24.9 years. The commonest manifestations were: purpura, epistaxis, gum-bleeding and menorrhagia. The duration of symptoms ranged from one month to over ten years (median 4.5 months). The platelet counts ranged from 4000/mm3 to 77,000/mm3 (mean - 19,200/mm3), haemoglobin 3.01 to 15.4 gm/dl (mean - 8.2 gm/dl). Four (11.8%) patients were not treated; of these, one went into spontaneous remission. Thirty patients (88.2%) were treated with prednisolone 1.0 to 1.5 mg/kg/day orally. Of these, 7 (23.3%) had excellent, 2 (6.7%) good, 6 (20%) fair, and 15 (50%) had poor responses. Ten patients had splenectomy with 5 (50%) excellent 2 (20%) good, 2 (20%) fair and 1 (10%) poor response. One patient with refractory ITP was treated with immunosuppressive drugs and had an excellent response. Fifteen patients are alive and on followup 3-122 months (median 33 months) after diagnosis, fifteen are lost after followup of 1-66 months (median 9 months) and four have died 1-18 months (median 2 months) after diagnosis. Chronic ITP is frequently seen in adult Ethiopians, its clinical features and response to therapy are similar to those reported in the literature.
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