Corticosteroid in the treatment of moderate to severe thrombocytopenia due to leptospirosis

Abstract EN

Background : Thrombocytopenia is associated with a bad prognosis in Leptospirosis.

Objectives : We investigated the effect of corticosteroids to improve thrombocytopenia due to leptospirosis.

Patients and Methods : In a clinical trial, all patients admitted with leptospirosis in Razi Hospital of Ghaemshahr, north of Iran were enrolled in a 2-year study.

Totally, 56 patients with moderate to severe thrombocytopenia were randomized to control and treatment groups.

The treatment group received corticosteroid (prednisolone 1 mg / kg / day for maximum one week) in addition to the standard antibiotic therapy.

Results : There was no significant difference regarding age and gender between the two groups (P = 0.254, P = 0.789, respectively).

The mean duration to improve thrombocytopenia was 4.41 ± 0.197 days in the treatment group and 5.72 ± 0.318 days in the control group, which was significantly different (P = 0.003).

Duration of hospitalization in the treatment group was 5.24 ± 0.244 days and 6.23 ± 0.329 days in the control group, which was significantly different (P = 0.028).

The two groups had no significant difference regarding mortality, intubation, level of platelet, duration of ICU admission and pulmonary, renal or hepatic involvement.

Conclusions : Corticosteroid therapy decreased the length of hospitalization only in severe subgroup thrombocytopenia, but not in the moderate subgroup.