Changing trends in the UK management of childhood ITP.
OBJECTIVE
To compare the treatment of childhood immune thrombocytopenia (ITP) with historical practice in the UK.


METHODS
Data collection through a national UK Childhood ITP registry (http://www.uk-itp.org) started in January 2007.


METHODS
UK hospitals.


METHODS
Children admitted with a new diagnosis of acute ITP and their treating physicians.


METHODS
Bleeding severity, platelet count, disease management and outcome from the time of presentation to 6 months.


RESULTS
Data from 225 children were analysed. 54% of children had clinically mild, 42% had moderate and 4% had severe disease as defined previously. The mean platelet counts at diagnosis for these groups were 14, 8 and 6×10(9)/l respectively. Children with mild disease had fewer bleeding sites (1.9), compared with moderate (2.5) or severe disease (3.6). There was one intracranial haemorrhage reported. At 6 months' follow-up, 32% had a persistent platelet count <150×10(9)/l, but only 4.8% had a count <20. The proportion of UK children receiving platelet-raising treatment was noted to decrease from 61% in 1995 to 38% in 2000. The current UK 2009 registry data show a continued decrease in treatment to 16% of all the children. In contrast, historical international data report 69% of children receiving interventional therapy.


CONCLUSIONS
The current UK practice has shown a continued reduction in the number of children receiving treatment in comparison with historical data and international practice.
The University of Manchester, Manchester Academic Health Science Centre, Royal Manchester Children's Hospital, Manchester M13 9WL, UK. john.grainger@cmft.nhs.uk
John D
JD
Grainger
Joanne L
JL
Rees
Marie
M
Reeves
Paula H B
PH
Bolton-Maggs
D000208:Acute Disease; D002648:Child; D002675:Child, Preschool; D004363:Drug Utilization / Q000639:trends; D004812:Epidemiologic Methods; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008297:Male; D010976:Platelet Count; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000639:trends; D011379:Prognosis; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000150:complications / Q000628:therapy*; D006113:United Kingdom
D005938:Glucocorticoids; D016756:Immunoglobulins, Intravenous