Evaluation of Japanese practice guidelines for newly diagnosed childhood idiopathic thrombocytopenic purpura.
BACKGROUND
Practice guidelines for childhood idiopathic thrombocytopenic purpura (ITP) were proposed in 1998 and 2004 in Japan. It is important to evaluate the feasibility and validity of the guidelines because the guidelines are based not on evidence but on opinion.


METHODS
Records of 30 consecutive hospitalized patients aged 0-15 years (median, 3 years; 17 boys, 13 girls) were retrospectively reviewed. The feasibility and validity of the 2004 guidelines were evaluated by calculating an implementation rate, a response rate to first treatments, and a final clinical outcome.


RESULTS
Deviation from the guidelines was found in two patients. Management of the other 28 patients followed the guidelines. The implementation rate was 93.3%. Twenty-one of the 28 eligible patients (75%) responded to the first treatment, whereas seven patients (25%) required additional treatment. In 23 patients (76.7%) platelet counts returned to normal within 6 months. Seven patients (23.3%) developed chronic conditions. All patients had no complications and achieved a platelet count >150 000/µL within 6 years.


CONCLUSIONS
The 2004 Japanese guidelines are feasible and valid for the management of newly diagnosed childhood ITP patients.
Department of Pediatrics, Yamada Red Cross Hospital, Ise, Mie, Japan.
Masamune
M
Higashigawa
Department of Pediatrics, Yamada Red Cross Hospital, Ise, Mie, Japan.
Tomohiro
T
Yamamoto
Department of Pediatrics, Yamada Red Cross Hospital, Ise, Mie, Japan.
Ayako
A
Yoshino
Department of Pediatrics, Yamada Red Cross Hospital, Ise, Mie, Japan.
Yuji
Y
Nashida
Department of Pediatrics, Yamada Red Cross Hospital, Ise, Mie, Japan.
Tomoaki
T
Maji
Department of Pediatrics, Yamada Red Cross Hospital, Ise, Mie, Japan.
Takashi
T
Fujiwara
Department of Pediatrics, Yamada Red Cross Hospital, Ise, Mie, Japan.
Masakazu
M
Inoue
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007564:Japan; D008297:Male; D017410:Practice Guidelines as Topic; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000628:therapy*