Abstract

ALFARO-TOLOZA, Patricio; OLMOS-DE-AGUILERA, Romina; GATICA ARANEDA, Juan Pablo  and  ANDREU CUELLO, Juan Pedro. Treatment of Inmune Thrombocytopenic Purpura whit high doses of steroids in patients with Diabetes Mellitus and Morbid Obesity, a metabolic challenge. Rev Cient Cienc Méd [online]. 2012, vol.15, n.1, pp.41-43. ISSN 1817-7433.

The immune thrombocytopenic purpura management with high doses of corticosteroids in patients with diabetes mellitus and morbid obesity is not defined.A 64 years old woman with morbid obesity, type 2 diabetes mellitus and immune thrombocytopenic purpura, presents sever thrombocytopenia with 2000 platelets, associated to extensive bruising in both legs and decompensate glucose. It was treated with Methylprednisolone 500 mg for three days and then Prednisone 60 mg/day, at the fifth day the dose was increased to 110 mg/day. Metformin was used (859 mg/ three times daily), NPH insulin and crystalline insulin achieving an average capillary glycemia of 322 mg/dl (first day) and 122 mg/dl (thirteenth day). At the fourteenth day with a recount of 86000 platelets she was discharged with oral treatment and clinical control. Metabolic compensation was achieved with high doses of NPH insulin and Metformin. It is possible to use high doses of corticosteroids in patients with type 2 diabetes mellitus and morbid obesity.

Keywords : Idiopathic   Thrombocytopenic Purpura; Diabetes Mellitus Type 2; Morbid Obesity.

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