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Predictor Factors for Chronicity in Immune Thrombocytopenic Purpura in Children
Vasile Eduard Rosu1, Solange Tamara Roșu2, Anca Viorica Ivanov1
1Pediatrics, "Grigore T. Popa" University of Medicine and Pharmacy, 700115 Iasi, Romania.
Insights
In children with immune thrombocytopenia (ITP), males and younger children show higher remission rates. Platelet count over 10 × 10^9/L at diagnosis also indicates a better prognosis for ITP.
Area of Science:
- Pediatric Hematology
- Autoimmune Disorders
- Blood Cell Disorders
Background:
- Immune thrombocytopenia (ITP) is a primary autoimmune cause of thrombocytopenia in children.
- Characterized by low platelet counts (<100 × 10^9/L), ITP can lead to severe complications like intracranial hemorrhage.
- Chronic ITP persists beyond 12 months post-diagnosis.
Purpose of the Study:
- To characterize clinical features of pediatric ITP.
- To identify prognostic factors influencing ITP outcomes in children.
Main Methods:
- Retrospective study conducted over 10 years (2011-2020).
- Data collected from 271 pediatric ITP patients at Emergency Clinical Hospital for Children, Iasi.
- Analysis focused on demographic, clinical, and prognostic variables.
Main Results:
- A total of 271 children (123 female, 148 male) were included.
- Higher remission rates observed in males (68.9%) compared to females (56.1%).
- Children under 9 years and those with initial platelet counts >10 × 10^9/L had better remission likelihood.
Conclusions:
- Younger age at diagnosis is associated with better ITP outcomes.
- Female sex and lower initial platelet counts (<10 × 10^9/L) are risk factors for chronic ITP.
- These factors aid in predicting disease persistence in pediatric ITP.
Abstract:
(1) Background: Immune thrombocytopenia (ITP) is an acute autoimmune blood disorder that is the main cause of thrombocytopenia in children. It is characterized by a decrease in platelets below 100 × 109/L, and limited evolution with severe complications such as intracranial hemorrhage. The chronic form is defined by the persistence of thrombocytopenia more than 12 months after diagnosis. (2) Methods: We performed a retrospective study over a period of 10 years (1 January 2011-31 December 2020) at the Emergency Clinical Hospital for Children "Sf. Maria", Iasi. The aim of the study was to describe the clinical characteristics and to determine the prognostic factors in immune thrombocytopenia in children. (3) Results: In this study we included 271 children with ITP, comprising 123 females (45.4%) and 148 males (54.6%). The remission rate was higher in males, being 68.9% compared to 56.1% in females. Children with ITP under 9 years of age had a higher remission rate. Children with a platelet count > 10 × 109/L at diagnosis had a higher likelihood-of-remission rate compared to patients who presented initial platelet count below this value. (4) Conclusions: The risk factors highly suggestive for chronicity are: age at diagnosis, female sex, and the number of platelets at the onset of the disease.
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