Clinical features and treatment outcomes of 79 infants with immune thrombocytopenic purpura.
BACKGROUND
To determine the clinical features and treatment outcomes of infants with immune thrombocytopenic purpura (ITP).


METHODS
Retrospective analysis of 79 infant ITP patients treated from 1987 to 2002. The data abstracted comprised age, gender, clinical features, and treatment outcomes. A score test for the trend in the odds ratios was used to determine the risk of chronic ITP with advancing age. The infants were compared to a group of contemporaneous older children with regard to bleeding severity and incidence of chronic ITP.


RESULTS
The 34 female and 45 male infants had a median age of 16 months. Seventy-four presented with purpura, four with viral illnesses, and one was asymptomatic. Eight percent had active mucosal bleeding. The median platelet count was 8,000/microl. Forty infants received intravenous immunoglobulin, nine intravenous anti-D immunoglobulin, six steroids, and seven were observed without treatment. Fifty-five (76%) responded to a single course of treatment. Only 9% of infants developed chronic ITP compared to 18% of children between the ages of 25 and 119 months and 47% of children 120 months or older (P<0.0005).


CONCLUSIONS
Infants with ITP respond favorably to treatment and are less likely to develop chronic ITP compared to older children.
Sandoval
Claudio
C
Department of Pediatrics and the Graduate School of Health Sciences, New York Medical College, Valhalla, New York 10595, USA. claudio_sandoval@nymc.edu
Visintainer
Paul
P
Ozkaynak
M Fevzi
MF
Tugal
Oya
O
Jayabose
Somasundaram
S
D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D006470:Hemorrhage; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000627:therapeutic use*; D015994:Incidence; D007223:Infant; D008297:Male; D010976:Platelet Count; D011247:Pregnancy; D011696:Purpura, Thrombocytopenic / Q000188:drug therapy* / Q000453:epidemiology; D012189:Retrospective Studies; D018029:Rho(D) Immune Globulin / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D016756:Immunoglobulins, Intravenous; D018029:Rho(D) Immune Globulin