An assessment of the effectiveness of splenectomy in the treatment of immune thrombocytopenia in adults

Abstract Introduction: Immune thrombocytopenia (IT) is an acquired immune-mediated disease characterized by a decrease in platelet count due to antiplatelet autoantibody-mediated increased platelet destruction. Platelets which are “labelled” by autoantibodies are recognized and destroyed first of all in the spleen, and, therefore, splenectomy is one of the treatment options, particularly in cases refractory to conservative treatment. The objective of this study was to determine long-term outcomes of splenectomy in the treatment of IT in adult patients. Materials and methods: Eleven patients, 7 men and 4 women with a mean age of 43 years and IT lasting 30 months on average underwent splenectomy. Indication to surgery was failed conservative steroid therapy in all patients. Outcomes of surgery were assessed in 9 patients on average 5 years following the surgery. Results: In all patients, good response to the treatment was obtained (remission). None of the patients continued therapy against the disease and all had platelet count at the follow-up higher than 100 G/L. No serious complications were observed. Conclusion: Splenectomy is an effective and relatively safe, second-line treatment of IT, in cases in which conservative therapy fails.