We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Article |

High-Dose Intravenous Methylprednisolone for Childhood Idiopathic Thrombocytopenic Purpura-Reply

Am J Dis Child. 1988;142(12):1273-1274. doi:10.1001/archpedi.1988.02150120027023.
Text Size: A A A
Published online


In Reply.—Thrombocytopenia may, as suggested by Dr Özsoylu, accompany megaloblastic anemia; rarely, it can precede the onset of overt anemia. To our knowledge, however, thrombocytopenia does not precede those early and more specific blood smear changes such as granulocytic hypersegmentation or erythrocytic macro-ovalocytosis, which characterize megaloblastic anemia.1 Likewise, the mean erythrocyte corpuscular volume is increased early in the course of megaloblastic anemia, as well as in various forms of marrow failure. Hence, our recommendation to include the peripheral blood smear examination and the mean corpuscular volume among those parameters on which the decision to perform a bone marrow aspiration in a suspected case of ITP is taken.

The usefulness of platelet serology in the diagnosis of ITP has recently been addressed in an editorial, the title of which leaves little doubt as to its conclusions: "Are Platelet-Antibody Tests Worthwhile?"2 We agree with Dr Özsoylu that some tests detecting platelet-associated


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.