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Immune Thrombocytopenia in Finnish Children and Adolescents: A Population-Based Cohort Study
Lauri-Matti Kulmala1, Henri Aarnivala1,2, Tytti Pokka3,4
1Research Unit of Clinical Medicine, University of Oulu, Oulu, Finland.
Insights
Most children with immune thrombocytopenia (ITP) recover quickly. Chronic ITP is more likely with insidious onset, higher platelet counts, and no recent infections, particularly in females.
Area of Science:
- Pediatric Hematology
- Immunology
Background:
- Immune thrombocytopenia (ITP) is the most frequent cause of low platelet counts in children.
- Understanding ITP diagnostics, patient profiles, and treatments is crucial for pediatric care.
Purpose of the Study:
- To characterize diagnostics, patient demographics, and treatment approaches for pediatric ITP.
- To identify risk factors associated with the development of chronic ITP in children.
Main Methods:
- A cohort study of 403 Finnish children under 16 diagnosed with ITP between 2006 and 2020.
- Analysis of patient characteristics, disease onset, treatment, and outcomes, including chronic disease development and bleeding events.
Main Results:
- 65.9% of children recovered within three months; 25.9% developed chronic ITP.
- Severe bleeding occurred in 3.7% of patients, with no reported intracranial bleeds or deaths.
- Insidious onset, female gender, older age, higher platelet counts, and absence of recent viral infections were linked to chronic ITP.
Conclusions:
- The majority of pediatric ITP cases have short, uncomplicated courses.
- Factors like insidious onset, non-critical platelet counts, and lack of recent infection increase the likelihood of chronic ITP.
Aim:
Immune thrombocytopenia (ITP) is the most common cause of thrombocytopenia in children. This study aimed to describe the diagnostics, patient characteristics, and treatment strategies regarding children with ITP, as well as identify risk factors for chronic disease.
Methods:
This study included 403 Finnish children aged under 16 years at diagnosis, who were first diagnosed with ITP between 2006 and 2020.
Results:
Of the 367/403 patients with complete follow-up data, 242 (65.9%) recovered within three months. Chronic ITP developed in 25.9% of the children. Severe bleeding events occurred in 3.7% of them, with no intracranial bleeding events or deaths reported. Pharmacological treatment was administered to 40.2% of the patients. An elevated risk of chronic ITP was found in the children presenting with an insidious disease onset, female gender, higher age, higher platelet counts, and an absence of recent viral infections. As many as 83.3% of the patients with an insidious disease onset and no recent infections developed chronic ITP.
Conclusion:
Most of the children with ITP experienced short and uncomplicated disease courses. Chronic illness was more likely when the disease onset was insidious, the platelet count was not extremely low, and there was no recent history of an infection.
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