ISSN: 1300-7777 E-ISSN: 1308-5263
Effects of high-dose methylprednisolone therapy on lymphocyte subtypes in patients with acute immune thrombocytopenic purpura [Turk J Hematol]
Turk J Hematol. 2005; 22(4): 185-189

Effects of high-dose methylprednisolone therapy on lymphocyte subtypes in patients with acute immune thrombocytopenic purpura

Ahmet Faik Öner1, Ali Bay1, Mehmet Kuru1, Abdurrahman Üner1, Şükrü Arslan1, İmdat Dilek2
1Department Of Pediatric Hematology, Yüzüncü Yıl University School Of Medicine, Van, Turkey
2Department Of Hematology, Yüzüncü Yıl University School Of Medicine, Van, Turkey

The aim of this study was to determine the effect of high-dose methylprednisolone (HDMP) on lymphocyte subtypes, CD4/CD8 ratio and clinical efficacy of the treatment in children with acute immune thrombocytopenic purpura (ITP). The study consisted of 21 children (aged between 1.5-14 years) with ITP treated with HDMP for 7 days. Absolute lymphocyte count, CD4+ and CD8+ T lymphocyte levels were examined on peripheral blood and CD4/CD8 ratio was calculated before and after HMTP treatment (on 0 and 8th days) in all subjects. There was no statistically significant difference for age and sex between the study and the control group. A significant reduction was observed in the percentage of CD4+ lymphocyte (39.0 ± 7.5% vs 29.3 ± 8.1%, p= 0.001), CD8+ lymphocyte (27.1 ± 7.2% vs 23.7 ± 8.3%, p= 0.03), CD4+/CD8+ (1.5 ± 0.5 vs 1.3 ± 0.4, p= 0.02) and the absolute number of CD4+ lymphocyte count (1694.99 ± 1019 vs 1199.12 ± 612, p= 0.038). These findings indicated that HDMP treatment may cause a decrease in the percentage of CD4+ and CD8+ T-lymphocyte and ratio of CD4+/CD8+ lymphocyte in patients with acute ITP. We suggest that the effectiveness of steroids may depended upon the suppression of CD4 T-lymphocyte and sequential monitoring of circulating lymphocyte subtypes may be used to predict the clinical effects of steroid treatment.

Keywords: Immune thrombocytopenic purpura, Lymphocyte subtypes, Steroid.


Akut immüntrombositopenik purpuralı hastalarda yüksek doz metilprednizolon tedavisinin lenfosit alt tipleri üzerine etkisi

Ahmet Faik Öner1, Ali Bay1, Mehmet Kuru1, Abdurrahman Üner1, Şükrü Arslan1, İmdat Dilek2
1Department Of Pediatric Hematology, Yüzüncü Yıl University School Of Medicine, Van, Turkey
2Department Of Hematology, Yüzüncü Yıl University School Of Medicine, Van, Turkey

Bu çalışmanın amacı; akut immüntrombositopenili (iTP) çocuklarda kullanılan yüksek doz metilprednizolon (YDMP) tedavisinin lenfosit alt tiplerine, CD4/CD8 oranına etkisini ve klinik etkinliğini saptamaktır. Bu çalışma yedi gün süreyle YDMP ile tedavi edilen, yaşları 1.5-14 yıl arasında değişen 21 çocuğu kapsamaktadır. Tanı anında ve YDMP tedavisinden sonra absolü lenfosit sayısı, CD4+ ve CD8+ T-lenfosit sayısı çalışıldı ve CD4/CD8 oranı hesaplandı. Çalışma grubu ve kontrol grubu arasında yaş ve cinsiyet açısından anlamlı fark yoktu. YDMP tedavisi sonunda CD4+ lenfosit yüzdesinde (%39.0 ± 7.5 vs %29.3 ± 8.1, p= 0.001), CD8+ lenfosit yüzdesinde (%27.1 ± 7.2 vs %23.7 ± 8.3, p= 0.03), CD4/CD8 oranında (1.5 ± 0.5 vs 1.3 ± 0.4, p= 0.02) ve absolü CD4 lenfosit sayısında (1694.99 ± 1019 vs 1199.12 ± 612, p= 0.038) anlamlı azalma görüldü. Bu bulgular göstermiştir ki akut iTP`li hastalarda YDMP tedavisi CD4+ ve CD8+ T-lenfosit sayısını ve CD4/CD8 lenfosit oranını azaltmaktadır. Steroid etkisinin CD4 lenfositlerinin baskılanmasına bağlı olabileceğini ve steroid tedavisinin etkinliğinin belirlenmesinde lenfosit alt tiplerinin monitörizasyonunun kullanılabileceğini düşünüyoruz.

Anahtar Kelimeler: İmmüntrombositopenik purpura, Lenfosit alt tipleri, Steroid.


Ahmet Faik Öner, Ali Bay, Mehmet Kuru, Abdurrahman Üner, Şükrü Arslan, İmdat Dilek. Effects of high-dose methylprednisolone therapy on lymphocyte subtypes in patients with acute immune thrombocytopenic purpura. Turk J Hematol. 2005; 22(4): 185-189

Corresponding Author: Ahmet Faik Öner, Türkiye


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