[Clinical course, diagnostic and therapeutic management of immune thrombocytopenic purpura in children].
OBJECTIVE
Immune thrombocytopenic purpura (ITP) is a common paediatric disease. Diagnosis of acute ITP is based on a platelet count less than 20 x 10(9)/L, with normal haemoglobin concentration and white blood cells count and absence of underlying conditions such as lymphoproliferative disorders or lupus erythematosus. The objective of this study was to present the clinical picture, the diagnostic procedures and therapeutic management of immune thrombocytopenic purpura in children treated in the Department of Paediatric Haematology and Oncology, Medical University, Lublin.


METHODS
The authors analysed complete medical records of 107 patients treated for immune thrombocytopenic purpura. The investigated group consisted of 39 boys and 68 girls with age varying from 2 to 17 years and 7 months. In 44 patients the peripheral platelet count was less than 20 x 10(9)/L, in 24 children the platelet count ranged between 20-30 x 10(9)/L, in others it varied between 30-50 x 10(9)/L. In 48 patients the physical examination revealed splenomegaly.


RESULTS
l. In 72 patients the cause of thrombocytopenia was established and included: in 24 patients -- upper respiratory tract infection, in 16 patients -- viral infections (varicella, rubella, mumps), in 19 patients -- CMV infection, in 7 patients -- EBV infection, in 6 patients -- contact with toxic substances; 2. In 5 patients thrombocytopenia episodes were diagnosed at least twice; 3. Typical presentation of acute ITP was observed in all patients; 4. Splenomegaly was confirmed in 48 patients by diagnostic ultrasound. 5. Thirty patients recovered spontaneously without treatment; 6. Treatment of 65 patients resulted in complete recovery; 7. In 11 patients after 3 to 6 months of observation, splenectomy was performed.


CONCLUSIONS
Therapeutic management of immune thrombocytopenic purpura in children treated in the Department of Paediatric Haematology and Oncology, Medical University, Lublin are comparable to the reports of Intercontinental Childhood ITP Study Group.
Mitura-Lesiak
Małgorzata
M
Klinika Hematologii i Onkologii Dzieciecej, Akademia Medyczna, ul. Chodzki 2, 20-093 Lublin, Poland. mamiles@poczta.onet.pl
Filiks-Litwin
Barbara
B
Malek
Urszula
U
Kowalczyk
Jerzy R
JR
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000175:diagnosis* / Q000628:therapy*; D012189:Retrospective Studies; D013156:Splenectomy