Ahmed Khan Chaudhry, Muhammad Azam.
Splenectomy; in idiopathic Thrombocytopenia (a retrospective review).
Professional Med J Jan ;11(2):190-6.

Objective: To assess the role of splenectomy in patients of idiopathic thrombocytopenic purpura. Design: It is a retrospective study. Place and Duration: This study was conducted at PNS Shifa Karachi, Combined Military Hospital Lahore and Military Hospital Rawalpindi spanning over last 10 years from 1993-2003. Subjects and methods: A total of 17 patients were included in the study, which were diagnosed as a case of idiopathic thrombocytopenic purpura after excluding other causes of thrombocytopenia. In all cases steroids were stopped either due to non responsiveness or severe side effects. Splenectomy was done in all 17 patients included in the study, after immunization and maintaining the platelet count with in near normal range by platelet transfusion. Post operative platelet count was monitored and improvement in clinical parameters was recorded. Results: All 17 patients showed improvement in platelet count and clinical symptom. Mortality remained zero despite of inclusion of high risk diabetics and hypertensives. Conclusion: when steroids become ineffective, splenectomy becomes the definitive therapeutic tool to control the effects of low platelet count.

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