EFFICACY OF HIGH-DOSE METHYLPREDNISOLONE IN PATIENTS WITH CRIMEAN-CONGO HEMORRHAGIC FEVER AND SEVERE THROMBOCYTOPENIA
Sharifi-Mood B., Alavi-Naini R., Metanat M., Mohammadi M., Shakeri A. and Amjadi A.
Professor of Infectious Diseases and Tropical Medicine, Infectious Diseases and Tropical Medicine Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
Crimean-Congo hemorrhagic fever (CCHF) is an acute viral hemorrhagic disease that is now endemic in southeastern Iran. The most important factor associated with mortality is platelet count less than 50,000 per milliliter (mL). A clinical trial was conducted for confirmed patients with CCHF and severe thrombocytopenia (platelet count less than 50,000/mL) who were admitted to Boo-Ali Hospital in Zahedan, between Jan 2010 to Oct 2011. Intervention group was given oral ribavirin, supportive managements and high dose methyl prednisolone (HDMP) and controls were treated with ribavirin and supportive management. Following HDMP therapy in hospitalized patients with severe thrombocytopenia, platelet count increased within 36 hours and leukocyte count within 48 hours of the beginning of treatment. A few patients required transfusion of blood products in intervention group comparing to controls (P<0.001). No patients died in intervention group. The increase platelet count and reduction of blood products requirement for severe CCHF patients after receiving HDMP are promising.
Keywords: CCHF, Methyl prednisolone and Thrombocytopenia