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ORIGINAL ARTICLE
Year : 2015  |  Volume : 28  |  Issue : 4  |  Page : 986-990

Steroid-induced renal dysfunctions in children with immune thrombocytopenia


1 Department of Pediatrics, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt
2 Department of Clinical Pathology, Faculty of Medicine, Menoufia University, Shebeen El-Kom, Egypt

Correspondence Address:
Abd Elfatah A Khalaf
Ard Elgamiat, 41511 Ismailia
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1110-2098.173697

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Objectives The study was designed to evaluate the effect of steroid therapy on renal functions in children with immune thrombocytopenia (ITP). Background ITP is usually a benign self-limiting condition. The most appropriate initial therapy for children with ITP remains controversial. When therapy is indicated, the primary method of treatment is steroid therapy. Materials and methods The study was conducted on 33 children newly diagnosed with ITP (19 male; 14 female). The patients were classified into two main groups: group I included patients who needed corticosteroid therapy (18 patients) and group II included patients who did not need corticosteroid therapy (15 patients). Fifteen healthy age-matched and sex-matched children were included in the study as controls. All individuals were subjected to history taking, thorough clinical examination, anthropometric measurements, complete blood count, complete urine analysis, and renal function tests [blood urea, serum creatinine concentrations, and estimated glomerular filtration rate (eGFR)]. Blood samples were taken before any treatment and after an accumulative dose of 350 mg/m 2 steroid therapy for group I. Results The study revealed that ITP children who received steroids had significant increase in serum creatinine and significant decrease in eGFR without difference in blood urea, compared with those who did not receive steroids and with controls. The same was true in paired analysis on comparing ITP patients after steroid therapy with their investigations before steroid therapy. Conclusion Patients with ITP under short course of corticosteroid therapy are at risk for impaired renal functions in the form of increased serum creatinine concentration and decreased eGFR.


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