Therapeutic effect of danazol on metrorrhagia in patients with idiopathic thrombocytopenic purpura (ITP).

Idiopathic thrombocytopenic purpura (ITP) is more frequently seen in young females than in any other age or sex group. Danazol, an impeded androgen with a decreased masculinizing potential, has been described as useful in ITP. A total of 25 women 16 to 41 years of age, with chronic ITP were studied. All patients were refractory to treatments with glucocorticoids and splenectomy; 19 were inadequately controlled by immunosuppressants, vinblastine or vincristine-loaded platelets, the radioimmune method, colchicine, plasmapheresis, or surgery for accessory spleens. Danazol was given at a daily dosage of 600 mg for 4 months. All showed clinical improvement, as indicated by cessation or decrease of bleeding, and 12 (48%) cases obtained a drug-dependent excellent or good response of their ITP. Therapy produced amenorrhea or oligomenorrhea in 21 patients (84%) and 7 cases of chronic metrorrhagia were successfully controlled. The drug was well tolerated. Accordingly, danazol may be an effective treatment for ITP or related conditions, especially in adult females with uncontrollable metrorrhagia.