Study on responses after splenectomy for idiopathic thrombocytopenic purpura patients, Kathmandu, Nepal.

Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by accelerated destruction of platelets due to the presence of platelet (Plt) auto antibodies and impaired production of platelets. Splenectomy is still the standard salvage therapy in cases refractory to corticosteroid therapy. Retrospectively we analyzed 34 patients with ITP that underwent splenectomy in the period May 2010 to March 2012 and have been followed for at least 12 months. All patients met the diagnostic criteria for ITP. The median age at diagnosis was 26 years (range: 14-55 years). Overall response rate to splenectomy after 1 year of follow up was 94.1%, with Complete response in 32 and no response or relapse in 2 (5.8%). Sex didn't influence the outcome after splenectomy in our group of patients. Only preoperative response to steroids (P value = 0.018) and post-operative platelet count (P value = 0.013) were found to be significant statistically. Splenectomy considered as safe and effective treatment for patients with ITP who failed to respond to firs-line treatment with corticosteroids. Management of patients who do not respond or relapse after splenectomy represent an important problem for further treatment due to low response rate to other treatment options.