Megadose methylprednisolone for Evans syndrome.

I was pleased to read Berber et al’s 50 year-old patient with Evans syndrome which was published as a Letter to The Editor in the recent issue of the Journal of Turgut Ozal Medical Center (2013;20(3):289-290). But, it was surprised to me that mega dose methyl prednisolone (MDMP) treatment was not brought to attention which had been successfully used for these patients first time from our country (1,2). Although it is a type corticosteroid administration treatment, it differs by its dosage (initially 30-100 mg/kg/day), the time of administration (around 6 a.m) (orally at once, intravenously 10-15 minutes) from conventional (1-2 mg/kg) uses divided doses, pulse methyl prednisolone (1000 mg given within 4 hours any time of the day, local injections intraocularly or by inhalation. MDMP administration is not only more effective, but also has less side effects (3,4). IVIG is not only very expensive, but also potentially harmful (5).