[Immune status of patients with idiopathic thrombocytopenic purpura in the delayed post-spelenectomy period].

The aim of the work was to evaluate results of the treatment of idiopathic thrombocytopenic purpura (ITP) in terms of relationship between immunity and clinical compensation of the disease, changes in the immune status of patients with its long duration, causes of long-term success or failure of splenectomy (SE) compared with cases treated by glucocorticoids alone. The study included 76 patients with chronic ITP of less than 1 year duration divided into 2 groups. 36 of them underwent SE and 40 were given prednisolone therapy. Examination included identification of lymphocyte subpopulations by flow cytometry, besides IgA, IgM, and IgG during exacerbation and remission (absence of hemorrhagic syndrome). It was shown that the major factors exerting negative effect after SE were elevated levels of total T-lymphocytes and their subpopulations (CD4+ and CD8+, especially T-helpers), B-lymphocytes, and IgM. Lower efficiency of conservative therapy with prednisolone was due to the absence of decrease in the absolute number of T-lymphocytes and changes in IgM.