Idiopathic thrombocytopenic purpura(
ITP) is an immunohematological disorder for which appropriate diagnostic and treatment strategies are unclear. In 1982 in Japan and 1996 in ASH, guideline for
ITP treatment was produced, respectively. These guidelines selected the
steroid for the first line treatment. Appropriate
steroid treatment was recommended based on the severity or grade of
bleeding and platelet counts. Patients with platelet counts above 50,000 do not require treatment ordinarily. Treatment was indicated in-patients with platelet counts under 20,000-30,000, and those with platelet counts under 50,000 with presence of
bleeding tendency or risk factor for
bleeding. Most
ITP patients responded well with initial
steroid treatment and 33% of them had a complete remission from
ITP, but remaining patients decreased platelet counts with the
steroid dose reduction. The management of the
bleeding symptoms without the adverse effects is an important point of
steroid medication in
ITP after first line treatment.