title: Initial management of children with newly diagnosed idiopathic thrombocytopenic purpura in the Nordic countries.
abstract: OBJECTIVE
  To describe the management practices of newly diagnosed childhood idiopathic thrombocytopenic purpura (ITP) in the Nordic countries.
  
  
  METHODS
  A prospective registration was done from 1998 to 2000, including all children with newly diagnosed ITP aged 0-14 years and at least one platelet count < 30 x 10(9)/L.
  
  
  RESULTS
  506 children from 98 departments were registered. A diagnostic bone marrow aspiration was obtained within 14 days in 33%. Platelet and/or red blood cell transfusion was given in 11%. 287 children (57%) received platelet-enhancing therapy with intravenous immune globulin (IVIG) or corticosteroids within 14 days of diagnosis, IVIG being the first line choice in over 90% of the cases. There were noticeable national differences in the management. The decision to start drug treatment within two days of diagnosis was influenced mainly by the platelet count. Neither early treatment nor response to treatment changed the risk of chronic disease.
  
  
  CONCLUSIONS
  This study has shown a great variation in the management practices of children with newly diagnosed ITP. Prospective studies are required to produce evidence-based recommendations for this patient group.
authors.affiliation: Paediatric Department of Sachs' Children's Hospital, Stockholm, Sweden. iris.treutiger@sos.ki.se
authors.forename: Iris
authors.initials: I
authors.lastname: Treutiger
authors.forename: Jukka
authors.initials: J
authors.lastname: Rajantie
authors.forename: Bernward
authors.initials: B
authors.lastname: Zeller
authors.forename: Göran
authors.initials: G
authors.lastname: Elinder
authors.forename: Steen
authors.initials: S
authors.lastname: Rosthöj
authors.lastname: NOPHO ITP Working Group
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003718:Denmark; D005387:Finland; D006801:Humans; D007055:Iceland; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007223:Infant; D009664:Norway; D011446:Prospective Studies; D011696:Purpura, Thrombocytopenic / Q000175:diagnosis / Q000188:drug therapy*; D013548:Sweden
chemical_list: D000305:Adrenal Cortex Hormones; D016756:Immunoglobulins, Intravenous