Effect of Corticosteroid therapy used in treatment of ITP on B Cell Function of pancreas

Abstract

This study was conducted at the hematology pediatric Clinic at pediatric hospital, Ain Shams university on 46 patients with ITP which were divided into 2 groups. Group A (23) included patients on chronic low dose steroid 1-2 mg /Kg/day for more than one week and Group B (23) included patients on episodic high dose corticosteroids 20-30 mg for 2-3 days and followed up at hematology pediatric hospital The aim of this work was to study the effect of standard (low dose) and high dose corticosteroid therapy used in the treatment of ITP on beta cell function of the pancreas. All patients included in the study were subjected to detailed history taking with special emphasis on bleeding tendency ,sites of bleeding, frequency ,symptoms of anemia, dose and duration of steroid therapy, symptoms of hyperglycemia as polyuria, polydypesia. Full clinical examination and laboratory investigations which included CBC, FBS, PPBS, serum insulin and HOMA equation. Our results showed that patients with ITP were 17 (36.5%) male and 29 (63.1%) females with more predominance of female affection. Their ages mean was 9.8 years. In the present study, platelet count was higher among higher dose steroid group (102) than lower dose steroid group (63.8)and the difference in between was statistically significant, P <0.01. Higer dose steroid had better impact on platelet count . The present study showed that the frequency of anemia was higher among low dose steroid group (26%) than high dose steroid group (0%) and the difference in between was statistically significant, P <0.01. In this study, FBS, PPBS were higher among high dose steroid group than lower dose steroid group and the difference in between was statistically significant, P <0.01 but it did not reach to the development of clinical diabetes. It showed also that serum insulin and HOMA were higher among high dose steroid group than lower dose steroid group and the difference in between was statistically significant, P <0.01. This showed higher insulin resistances among the high dose group