Onyalai (a form of idiopathic thrombocytopenic purpura) in the United States. A report of two patients

Mega-dose intravenous methylprednisone for the treatment of onyalai: a case report

Onyalai, a peculiar manifestation of idiopathic thrombocytopenic purpura characterized by a haemorrhagic bullae of the oral mucosa and lips, was diagnosed in a 1.5-month-old Turkish boy. He was treated with mega-dose intravenous methylprednisolone (30 mg/kg for 3 days) with prompt platelet response and improvement of oral mucosal findings.

Diagnosis and management of onyalai

Onyalai is diagnosed by finding the combination of haemorrhagic blisters in the mouth and severe thrombocytopenia, and by excluding other possible causes of thrombocytopenia. Patients improve rapidly with appropriate therapy. Haemorrhagic shock should be corrected with intravenous fluid and blood transfusion. Corticosteroids should be given in large doses initially, then tapered off and stopped over a period of several weeks. Occasional patients may require more prolonged steroid therapy.