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Thrombocytopenia in childhood: an evaluation of 433 patients
Insights
This study evaluated 433 children with thrombocytopenia in Denmark (1959-1969). Most cases followed infections, with spontaneous recovery common, and treatment outcomes similar across groups.
Area of Science:
- Pediatrics
- Hematology
- Epidemiology
Background:
- Thrombocytopenia in children presents a significant health concern.
- Understanding its incidence, causes, and outcomes is crucial for pediatric care.
- Previous studies on childhood thrombocytopenia in Denmark are limited.
Purpose of the Study:
- To evaluate the incidence, etiology, clinical course, and outcomes of childhood thrombocytopenia in Denmark.
- To identify risk factors and common causes of thrombocytopenia in pediatric patients.
- To compare treatment outcomes for spontaneous recovery, glucocorticoid therapy, and splenectomy.
Main Methods:
- Retrospective analysis of 433 children diagnosed with thrombocytopenia between 1959 and 1969 in Denmark.
- Data collection included patient demographics, clinical presentation, preceding infections, congenital factors, treatments, and outcomes.
- Incidence rates were calculated based on age-specific population data.
Main Results:
- An incidence of 31.9 cases per million children (<15 years) annually was observed, peaking at ages 3-4, with a spring seasonality.
- Infections, particularly upper respiratory tract infections with fever, were the most common preceding cause.
- Congenital cases were often hereditary and linked to immune system malformations. Mortality was 1.4%, primarily due to underlying disorders or hemorrhage. Follow-up platelet counts showed no significant differences between treatment groups.
Conclusions:
- Childhood thrombocytopenia in Denmark during 1959-1969 had a defined incidence and common triggers like infections.
- Congenital forms were associated with hereditary factors and immune system issues.
- Treatment approaches, including watchful waiting, glucocorticoids, and splenectomy, yielded similar long-term platelet count outcomes.
Abstract:
An evaluation of 433 children with thrombocytopenia is presented. The material comprises all cases diagnosed in Denmark during the period 1959-1969. The incidence was found to be 31.9 cases per 1,000,000 inhabitants less than or equal to 15 years of age per annum with a peak at the age of 3 to 4 years; the majority of the cases was diagnosed in the spring. Preceding infection, usually associated with fever and localized in the upper respiratory tract, was the most common cause. The majority of the congenital cases was hereditary and associated with other malformations involving in particular the immune system. In about half of the cases the course was spontaneous and no treatment was necessary; the remaining patients were treated with glucocorticoids, including 46 patients, who had undergone splenectomy. 22 patients died, including 16 cases due to serious underlying disorders; in 6 cases the cause of death was haemorrhage (mortality rat=1.4%). At the follow up the platelet count was below 50 mia/1 in 14 patients (4%). No difference was found concerning the platelet count at the follow up between the patients with spontaneous recovery, the patients treated with glucocorticoids and the patients, in whom splenectomy had been performed. During the course the disease autoimmune haemolytic anaemia occurred in 2 patients, whereas no patient developed systemic lupus erythematosus.
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