الفهرس 
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Abstract
Primary immune thrombocytopenia (ITP) characterized by thrombocytopenia in the absence of other causes. ITP is a condition associated with platelet destruction by antiplatelet antibodies. The most important criterion for its diagnosis is platelet count <100 × 109 /L. However, the platelet count is not the only diagnostic criteria, as the diagnosis is depending on other findings. Based on duration, it classified into newly diagnosed, persistent and chronic ITP.
Mortality in these patients is due to bleeding as well as complications of treatment. About one-third of the patients treated with steroid will have a long-term response. The treatment of choice for patients who have failed steroid therapy is splenectomy. This option associated with a higher rate of cure with partial and sustained complete response rates of 12% and 60%. Many patients resistant to corticosteroids and splenectomy, further treatment options as immunosuppression required
A single-agent immunosuppressive drug has not induced a prolonged remission successively, sometimes it associated with unwanted adverse events. Patients not responding to steroid and splenectomy with a platelet count <30 × 109 /L, further treatment should be considered as immunosuppressive therapy with methylprednisolone, cyclophosphamide, azathioprine, vincristine, danazol, gammaglobulin, anti-Rh(D), rituximab and cyclosporine A.
Here, in the current study we aimed estimate frequency of viral HB & C infection in ITP patients who received triple therapy in comparison with another group treated with steroids only. In addition to compare between efficacy of both regimens of therapy in management of ITP.
The study enrolled a total of 100 patients with clinical and laboratory, evidence of ITP. Those patients were subdivided based on therapy; group A, included 50 patients with ITP received triple therapy and group B, included 50 patients with ITP received steroid therapy.
The main findings of the current study were; 1) no case was detected to have viral infection either before therapy or 6-months after 6-months of therapy, 2) triple therapy was more effective than steroids therapy with significantly higher platelets count at 6 months after therapy (178.98 ± 12.12 vs. 145.67 ± 20.20 (103/ul); p< 0.001) and 3) random blood sugar was significantly lower in Steroid therapy group (190.45 ± 45.32 vs. 245.67 ± 55.56 (mg/dl); p< 0.001).
In conclusion; triple therapy is a safe well tolerated and effective therapy for patients with ITP. Future studies with large number of patients in multiple centers are warranted to confirm such findings.