Management of acute childhood idiopathic thrombocytopenic purpura according to AIEOP consensus guidelines: assessment of Italian experience.
BACKGROUND
Consensus guidelines for diagnosis and treatment of acute childhood idiopathic thrombocytopenic purpura (ITP) were published in 2000 by the Italian Association of Pediatric Haematology and Oncology (AIEOP). The assessment of guideline implementation was the primary objective of the present study.


METHODS
Information on each newly diagnosed case of ITP referring to centres conforming with the guidelines was obtained by a questionnaire.


RESULTS
Data concerning 609 new cases of acute childhood ITP were collected including 346 (56.8%) asymptomatic-paucisymptomatic forms (type A), 262 (43%) intermediate clinical forms (type B), and 1 (0.2%) severe form (type C). At diagnosis, 82% of cases were hospitalized. Age, platelet count and duration of hospitalization were significantly different in type A and type B cases. Of the total number of cases, 25% were kept under observation, 38.6% received intravenous immunoglobulins, 23.9% oral or parenteral steroids, and 12.7% other treatments. The initial treatment turned out to be appropriate for 428 cases (72.2%), of uncertain appropriateness in 71 (11.9%), and inappropriate in 95 cases (15.9%). The total level of implementation was 84.1%.


CONCLUSIONS
A high rate of guideline implementation was observed during the study period. The guidelines should be reviewed taking into account more recent evidence.
Del Vecchio
Giovanni Carlo
GC
Dipartimento di Biomedicina dell'Età Evolutiva, Università di Bari, Bari, Italia.
De Santis
Attilio
A
Giordano
Paola
P
Amendola
Giovanni
G
Baronci
Carlo
C
Del Principe
Domenico
D
Nobili
Bruno
B
Jankovic
Momcilo
M
Ramenghi
Ugo
U
Russo
Giovanna
G
Zecca
Marco
M
De Mattia
Domenico
D
D000208:Acute Disease; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007223:Infant; D007902:Length of Stay; D008297:Male; D010976:Platelet Count; D011446:Prospective Studies; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy / Q000628:therapy*; D011795:Surveys and Questionnaires
D000305:Adrenal Cortex Hormones; D016756:Immunoglobulins, Intravenous