Three decades of experience in managing immune thrombocytopenia in children in Arab countries

There are scattered and limited data in the literature on immune thrombocytopenia (ITP) in children from the Arab region. The aim of the current review is to present data from this region on the diagnosis, therapy, and morbidity associated with ITP. The first report was published three decades ago. It was assumed that there was a different disease pattern of ITP, but this was later discovered to be inaccurate and the frequencies of different ITP patterns were not different from other regions. The initial work-up for diagnosis of newly diagnosed ITP included routine bone marrow evaluation for all patients in most studies; however, a limited need for bone marrow for the initial evaluation was reported. An Egyptian multicenter study on the morbidity and mortality of intracranial hemorrhage (ICH) with other sporadic data was reported. Neither regional nor national guidelines for ITP management in most Arab countries have been reported. However, the use of initial intravenous immunoglobulin (IVIG) therapy in the Arabian Gulf region in contrast to corticosteroids in most other countries was obvious. Limited data on the use of anti-CD20, avoidance of unnecessary splenectomy, and the use of thrombopoietin receptor analogue in chronic ITP were published recently. A unified consensus for ITP management in the Arab region is essential but not yet realistic. More publications from this region are needed.