特発性血小板減少性紫斑病 (ITP)に関する臨床的研究 第2編 ITP の治療効果の解析とステロイド難反応性ITPに対するコルヒチン療法の意義について

Clinical effects of steroid and colchicine therapy in 49 patients with ITP especially the refractory cases were evaluated in comparison with splenectomy and danazol therapy.\nThere were 27(55%) steroid resistant patients who could not maintain platelet counts of 5×10(4)/μl with prednisolone doses of less than 10mg/day. Among the 16 steroid resistant patients treated with colchicine, there were 3 patients with complete remission and 3 others who had good to excellent response, that is, 6(37.5%) improved overall. This therapy was more effective than splenectomy (33.3%) and danazol (25%). Colchicine was did not effective in patients who did not respond to prednisolone, but was useful when patients showed at least a transient rise of the platelet count with prednisolone. In many cases, a response to colchicine was seen after a month, and in the patients who failed to show a rise in the platelet count after 2 months of colchicine therapy, no benefit was seen even when the therapy was continued. Colchicine is advantageous in the treatment of the steroid resistant ITP over the immunosuppressive agents or high-dose γ-globulin that are expensive and produce only a transient rise in the platelet count.