Idiopathic thrombocytopenic purpura diagnosed during the second decade of life.
OBJECTIVE
To retrospectively review our institutional experience of adolescents with idiopathic thrombocytopenic purpura (ITP).


METHODS
Medical record review of all patients diagnosed with ITP between the ages of 10 and 18 years seen at our center from January 1976 to March 2000.


RESULTS
Data were collected from 126 patients. Of the evaluable 110 cases, 63 (57%) satisfied the criteria for chronic ITP, 30 (27%) for acute ITP, and 17 (15%) were uncertain. Sex distribution and mean ages were similar in all 3 groups. Platelet count at presentation was higher in patients with chronic ITP. Splenectomy was performed in 24 patients, with 17 (77%) of 22 having normal platelet counts at last follow-up. Outcome for the nonsplenectomized patients with chronic ITP included normalization of platelet count (n = 4), minimal or no bleeding without treatment (n = 29), treatment for ongoing symptoms (n = 5), and unknown (n = 1). Two patients died, 1 from intracranial hemorrhage and 1 from Escherichia coli sepsis and pulmonary hemorrhage.


CONCLUSIONS
Patients 10 to 18 years of age with ITP are more likely than younger children to have chronic disease. Many patients with ITP recover without drug therapy or need for splenectomy. ITP in adolescents shares features of both childhood and adult ITP.
Division of Hematology-Oncology, Department of Pediatrics, the University of Texas Southwestern Medical Center at Dallas, Texas, USA.
Eric J
EJ
Lowe
George R
GR
Buchanan
D000293:Adolescent; D000974:Antibodies, Antinuclear / Q000097:blood; D002648:Child; D002669:Child Welfare; D003907:Dexamethasone / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000175:diagnosis* / Q000628:therapy; D012189:Retrospective Studies; D018029:Rho(D) Immune Globulin / Q000627:therapeutic use; D013156:Splenectomy; D013781:Texas; D016896:Treatment Outcome
D000974:Antibodies, Antinuclear; D005938:Glucocorticoids; D018029:Rho(D) Immune Globulin; D003907:Dexamethasone