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Treatment of Refractory Idiopathic Thromboctopenic Purpura.

Bertha A. Bouroncle, M.D., F.A.C.P.; and Charles A. Doan, M.D., M.A.C.P.
Ann Intern Med. 1968;68(5):1164. doi:10.7326/0003-4819-68-5-1164_2
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Splenectomy and corticosteroids are recognized therapeutic measures for the treatment of idiopathic thrombocytopenic purpura. In our overall evaluation of 271 patients, previously reported, 7.7% were refractory to both methods of therapy.

During the past 3½ years we have treated 16 of these cases of refractory idiopathic thrombocytopenic purpura for long-term therapy with the immunosuppressive drug azathioprine (Immuran®).

Doses of 1.2 to 4.2 mg/kg body weight (50 to 250 mg) daily, which were effective in obtaining a remission, have practically no toxic effects. Only two patients had moderate degree of leukopenia, which was rapidly reversible. The danger of producing a general




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