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Outcome of children with idiopathic thrombocytopenic purpura, based on original material
Joanna Zawitkowska-Klaczyńska1, Joanna Nurzyńska-Flak, Krzysztof Kattski
1Department of Paediatric Haematology and Oncology, Skubiszewski Medical University of Lublin.
Insights
Idiopathic or immune thrombocytopenia purpura (ITP) in children often resolves with corticosteroids. Chronic ITP may benefit from splenectomy, offering a good outcome for symptomatic cases.
Area of Science:
- Pediatric Hematology
- Immunology
- Clinical Research
Background:
- Idiopathic or immune thrombocytopenia purpura (ITP) is a prevalent hematologic disorder in pediatric populations.
- ITP classification into acute and chronic forms is determined by the duration of thrombocytopenia.
Purpose of the Study:
- To analyze the disease course and outcomes in children diagnosed with acute and chronic ITP.
- To evaluate treatment efficacy and long-term results for pediatric ITP patients.
Main Methods:
- Retrospective analysis of 52 pediatric patients with ITP treated between 1998 and 2002.
- Review of treatment modalities including corticosteroids, immunoglobulin, combined therapies, and splenectomy.
- Assessment of patient response to treatment and disease progression.
Main Results:
- A total of 52 children (28 girls, 24 boys) aged 1-17 years were included.
- Spontaneous recovery occurred in 3 patients; 33 responded well to steroids, one to immunoglobulin, and others to combined therapy.
- Nine children developed chronic ITP, with 6 undergoing successful splenectomy and 3 remaining under observation.
Conclusions:
- Corticosteroids are effective for the majority of acute ITP cases in children.
- Splenectomy provides significant benefits for children with markedly symptomatic chronic ITP, outweighing the associated risks.
Abstract:
Idiopathic or immune thrombocytopenia purpura (ITP) is a common hematologic disease in children. ITP is subdivided in an acute and chronic form based solely on the duration of thrombocytopenia. The aim of the study was to analyse the course of disease and outcome of children with acute and chronic ITP. The study enrolled 52 patients with ITP, who were treated in the Department of Pediatric Hematology and Oncology in Lublin from 1998 to 2002. Of the 52 patients with ITP there were 28 girls and 24 boys aged from 12 months to 17 years. Out of the 52 patients, 3 patients had spontaneous recovery, 33 were treated with steroids, one with immunoglobulin, others with combined therapy. Good response to treatment was found in 40 patients. Nine children developed chronic ITP. Out of 9 patients, 6 had splenectomy with good result and 3 are only observed. The benefits of splenectomy in markedly symptomatic chronic ITP far outweigh the risks. The majority of patients with acute ITP had good response after corticosteroids therapy.
