HD-DXM generated a good response in children with chronic ITP in our study, which was consistent with earlier reports.20–23 Among the mechanisms that mediate the effect of high-dose steroids on platelets in chronic ITP are their antagonistic effect on macrophage differentiation, suppression of the reticulo-endothelial system’s phagocytic activity, induction of lymphopenia, inhibition of activated T-lymphocytes, and reduction in autoantibody production.22,23 Prior to treatment, the number of CD4+Foxp3+ Tregs was significantly lower in children with chronic ITP. Here, CD4 is linked to lymphopenia.