Corticosteroid in the Treatment of Moderate to Severe Thrombocytopenia Due to Leptospirosis

Abstract

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.