title: Evaluation of clinical characteristics, diagnosis and management in childhood immune thrombocytopenic purpura: a single center's experience.
abstract: Diagnostic evaluation and management in childhood immune thrombocytopenic purpura (ITP) are controversial. We reviewed the files of 162 children with ITP to evaluate clinical characteristics, response to treatment and outcome. History of antecedent infection, vaccination and serologic evidence for acute viral infection were present in 48%, 5% and 17% of the patients, respectively. At diagnosis, two-thirds of the patients had a platelet count of <10,000/microl but only 10% had major bleedings. Intracranial hemorrhage was seen in two patients (1.2%) with a mortality rate of 0.6%. Sixteen percent developed chronic ITP. The rate of platelet recovery with mega-dose methylprednisolone (30 mg/kg/d for 3 and 20 mg/kg/d for 4 days) was similar to that obtained with intravenous immunoglobulin or oral prednisolone. Four of seven patients with ITP responded to splenectomy. These data show that mode of treatment has no effect on the clinical course and prognosis of childhood ITP.
authors.affiliation: Department of Pediatric Hematology, Gazi University Faculty of Medicine, Ankara, Turkey.
authors.forename: Ulker
authors.initials: U
authors.lastname: Koçak
authors.forename: Yusuf Ziya
authors.initials: YZ
authors.lastname: Aral
authors.forename: Zühre
authors.initials: Z
authors.lastname: Kaya
authors.forename: Gülyüz
authors.initials: G
authors.lastname: Oztürk
authors.forename: Türkiz
authors.initials: T
authors.lastname: Gürsel
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007223:Infant; D008297:Male; D008499:Medical Records; D008775:Methylprednisolone / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D010976:Platelet Count; D011696:Purpura, Thrombocytopenic / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D012008:Recurrence; D013156:Splenectomy
chemical_list: D000893:Anti-Inflammatory Agents; D016756:Immunoglobulins, Intravenous; D008775:Methylprednisolone