Evaluation of Initial Diagnosis, Clinical-Treatment Features of Children with Acute Immune Thrombocytopenia

Authors : Ersin Töret, Ezgi Baransel, Zeynep Canan Özdemir, Ozcan Bor

Pages : 221-226

Doi:10.20515/otd.1597007

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Publication Date : 2025-02-27

Article Type : Research Paper

Abstract :Primary immune thrombocytopenia (ITP), formerly known as idiopathic thrombocytopenic purpura, is the most common cause of thrombocytopenia in children, defined by an isolated low platelet count (<100,000/mm³) without other etiologies. It has an annual occurrence of approximately 2 to 5 per 100,000 children. Acute ITP presents with mucosal bleeding or skin manifestations at diagnosis, with classifications for acute, persistent, and chronic ITP based on the duration of the condition. Most children (70-80%) experience spontaneous recovery within 12 months. Both primary and secondary ITP exhibit immunological abnormalities, yet secondary cases are linked to identifiable etiological factors. The treatment objectives focus on halting active bleeding and preventing future bleeding, as well as enhancing health-related quality of life (HRQoL). Corticosteroids have been the mainstay of ITP treatment since the 1950s, with recent studies showing a trend toward reducing high-dose methylprednisolone (HDMP) use.This retrospective study was conducted in Turkey, analyzing 40 pediatric patients diagnosed with acute ITP who received intravenous methylprednisolone in two groups with varying doses. The results indicated that both treatment regimens achieved similar response rates, and there were no significant differences regarding relapse rates or the development of chronic ITP between the groups. Overall, while initial treatment response rates did not differ significantly, the study emphasizes the need to investigate dosing strategies for managing acute ITP effectively. The findings support the use of a ‘mega dose’ of methylprednisolone for the initial treatment phase, but suggest that a lower dose may be equally effective without compromising patient outcomes.
Keywords : akut immün trombositopeni, çocukluk çağı, kronikleşme, metilprednizolon.