RETROSPECTIVE EVALUATION OF THE OUTCOME OF IMMUNE THROMBOCYTOPENIA IN CHILDREN AND ADOLESCENTS: SINGLE CENTER EXPERIENCE | ||||
| Al-Azhar Journal of Pediatrics | ||||
| Article 5, Volume 27, Issue 1, January 2024, Page 3785-3799 PDF (134.8 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/azjp.2024.351099 | ||||
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| Abstract | ||||
| Background: Primary immune thrombocytopenia (ITP) represents the commonest cause of isolated thrombocytopenia among children & adolescents; that’s characterized by variable presentations and varied outcomes of disease differentiated into; acute, persistent, or chronic depending upon illness duration; with efforts made to increase knowledge about possible outcome predictors. Aim: we aimed to study disease characteristics & outcome predictors among 50 enrolled patients. Methods: This retrospective cohort study included collection of; demographic data, bleeding phenotype, Buchanan bleeding score onset of symptoms prior to diagnosis, proceeding viral infection or vaccination, initial platelet count & bone marrow finding, received treatment as well as; response to treatment among 50 patients already diagnosed as primary ITP child and adolescent which followed up since 2012 till 2020 in pediatric hematology clinic, Ain Shams University. Patients were further subdivided into acute, persistent & chronic ITP groups. Results: Among included cohort; 38 (76.0%) were males of median (IQR) age of 5.25 (2.5-8.5) years. Chronic ITP represented the most prevalent outcome in the cohort 58.0%(n=29), with acute ITP 32.0%(n=16) & persistent ITP 10.0% (n=5). Among the chronic ITP group in comparison to other groups; female was more than third the patients 34.5% (n=10), 72.4%(n=21) reported >2weeks disease related symptoms with no seasonal peaks of diagnosis, 10%(n=1) presented initially with menorrhagia, Yet no statistical differences between groups regarding associated autoimmune symptoms, bleeding score, nor initial platelet count (p= 0.91, p=0.078, p=0.955) respectively. All chronic ITP groups required steroids in initial treatment with significant difference in response to treatment & recurrence of the disease (p=0.00) as none showed complete remission and all patients experienced disease recurrence. Conclusion: Different presentation of primary ITP. e.g. gender, bleeding symptoms, treatment among children can potentially serve as clinical predictors of outcome. | ||||
| Keywords | ||||
| Chronic ITP; bleeding score | ||||
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