Factors Affecting Chronicity in Childhood Immune Thrombocytopenia

Authors : Emine ÇAMTOSUN, Mualla ÇETİN

Pages : 227-234

View : 18 | Download : 8

Publication Date : 2019-12-10

Article Type : Conference Paper

Abstract :Immune thrombocytopenic purpura insert ignore into journalissuearticles values(ITP); is the most common cause of childhood acquired thrombocytopenia. Spontaneous recovery within one year is common in acute cases. Whereas intravenous immunoglobulin insert ignore into journalissuearticles values(IVIG);, corticosteroids or anti Rh immunoglobulin insert ignore into journalissuearticles values(Anti-D); treatments are used to increase the platelet count rapidly in cases with high risk of bleeding or those with hemorrhage. We aimed to evaluate initial responses to various treatments in childhood ITP and factors affecting chronicity in a single center cohort of pediatric and adolescent ITP patients. MATERIALS AND METHOD: The study included 143 patients under the age of 18 who were followed-up with the diagnosis of ITP and who presented within initial 12 months of the disease within 18 years of duration. The initial treatment responses of acute ITP and the factors influencing chronicity were evaluated. FINDINGS: Of the 143 patients nine were lost the follow up, 81 patients insert ignore into journalissuearticles values(60,4%); exhibited resolution of thrombocytopenia within 12 months. The sex and mean age were not different between acuteinsert ignore into journalissuearticles values(aITP); and chronicinsert ignore into journalissuearticles values(cITP); patients insert ignore into journalissuearticles values(p>0,05);. But aITP was more frequent below two years old insert ignore into journalissuearticles values(p=0,027);. Patients who had insidious onset, who didn’t have antecedent history of infection had higher chronicity rates. Platelet count at diagnosis was higher in cITP group insert ignore into journalissuearticles values(p=0,037);. The median platelet count in the patients with cITP was 13,000insert ignore into journalissuearticles values(1000-122,000);, which was significantly higher than in acute cases 8000insert ignore into journalissuearticles values(1000-62000);/mm3insert ignore into journalissuearticles values(p=0.037);. Observation only, methylprednisoloneinsert ignore into journalissuearticles values(MP); and IVIG applied to aITP patients as initial therapies, and they had similar initial resolution/response rates insert ignore into journalissuearticles values(89,5%, 82,5%, 87,1% respectively);insert ignore into journalissuearticles values(p=0,811);. Steroid and IVIG therapies provided response faster than observation only insert ignore into journalissuearticles values(p<0,05);. CONCLUSION: There is higher risk of progression to chronicity from acute disease in patients with an insidious disease onset, not having history of previous infection, and higher platelet counts at diagnosis. Although the initial response rates to different treatment options in aITP were similar, responses to MP and IVIG were faster.
Keywords : Itp, Childhood, Treatment