[Idiopathic thrombocytopenic purpura (ITP) in childhood (author's transl)].
Half of thrombocytopenic purpuras occurs after a viral infection and is cured in a few weeks, but 10% of the cases are chronic. Toxic purpura is exceptional. Most of the cases are idiopathic. At the beginning it is impossible to foresee acute or chronic evolution. No treatment is necessary in ITP without serious bleeding. Prednisone does not avoid chronic state but shortened duration of acute ITP. Dosage is 1 mg/kg/day. Continuous corticotherapy is excluded in chronic ITP. Short corticotherapy is useful during bleeding periods. Splenectomy is to be considered after 6 or 12 months. Overall success raise 75%. Splenectomy is forbidden temporarily before 5 years, and definitely in immune deficiency. Immunosuppressive drugs are rarely used in childhood. Treatment with infusion of vincristine labeled platelets is in study. During the 18 months after cure, vaccinations must be avoided.
D002648:Child; D006801:Humans; D011241:Prednisone / Q000627:therapeutic use; D011696:Purpura, Thrombocytopenic / Q000175:diagnosis / Q000628:therapy*; D013156:Splenectomy; D013997:Time Factors
D011241:Prednisone
Traitement des purpuras thrombopéniques idiopathiques de l'enfant.