Chronic Idiopathic Thrombocytopenic Purpura (ITP): Site of Platelet Sequestration and Results of Splenectomy

Abstract

51Cr-platelet kinetics study was performed in 197 patients with chronic ITP [idiopathic thrombocytopenic purpura] after corticosteroid therapy had failed to induce a long lasting remission. The incidence of splenic, spleno-hepatic, hepatic and diffuse platelet sequestration site was 58%, 17%, 6% and 19%, respectively. Splenic and spleno-hepatic sequestration sites were more frequent in patients < 30 yr old and in patients with a platelet count lower than 50 .times. 109/l. Patients (111) were splenectomized shortly after the study. Normalization of the platelet count was obtained more frequently in patients with splenic and spleno-hepatic sequestration than in the others. Labeled platelet sequestration site was the best predictor of the outcome of splenectomy. Platelet kinetics is a non-invasive investigation that should be performed early after the diagnosis of chronic ITP in all patients eligible for splenectomy.