The British Journal of Rheumatology, Vol 36, 1095-1099, Copyright © 1997 by British Society for Rheumatology
R Blanco, VM Martinez-Taboada, V Rodriguez-Valverde, A Sanchez-Andrade and MA Gonzalez-Gay
The objective was to assess the efficacy of therapy with danazol in
refractory immune thrombocytopenia associated with different rheumatic
diseases. Patients with severe immune thrombocytopenia (platelet counts
< 40 x 10(9)/l) with a bone marrow biopsy showing megakaryocytes in
normal or increased number and normal morphology were included if they
fulfilled at least one of the following criteria: (a) thrombocytopenia
refractory to prednisone (> or = 1 mg/kg/day during > or = 4 weeks);
(b) patients requiring an unacceptably high dose of prednisone for > 2
months (prednisone dose > or = 20 mg/day); (c) no response to at least
another drug besides corticosteroids. Other causes of thrombocytopenia were
excluded. They were treated with danazol (100-200 mg q.i.d.) and followed
for at least 12 months. Four patients diagnosed with systemic lupus
erythematosus, two with rheumatoid arthritis and one with primary
antiphospholipid syndrome met the inclusion criteria. All of them achieved
acceptable platelet counts within the first 4 weeks of danazol therapy that
allowed the prednisone dosage to be tapered. No important side-effects
related to danazol therapy were observed. Danazol therapy seems to be a
useful and well-tolerated treatment for refractory immune thrombocytopenia
associated with different rheumatic diseases.
ORIGINAL PAPERS
Successful therapy with danazol in refractory autoimmune thrombocytopenia associated with rheumatic diseases
Division of Rheumatology, Hospital Xeral-Calde (Lugo), Spain.
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