title: Age and duration of bleeding symptoms at diagnosis best predict resolution of childhood immune thrombocytopenia at 3, 6, and 12 months.
abstract: OBJECTIVE
  To evaluate the predictive value of clinical features at diagnosis of immune thrombocytopenia (ITP) for resolution of disease.
  
  
  METHODS
  Hospital records of 472 consecutive children (<18 years old) with ITP cared for at 2 participating centers were reviewed retrospectively and data related to the initial presentation were recorded. Logistic regression analysis was used for calculating prediction of resolution at 3, 6, and 12 months from diagnosis.
  
  
  RESULTS
  The most significant predictors for resolution of ITP at 3, 6, and 12 months were age at onset <10 years and abrupt onset (history of <2 weeks of bleeding). We designed a prediction rule for ITP chronicity based on these criteria. The rate of developing chronic ITP for low, intermediate, and high risk children at diagnosis of ITP was 11%, 39%, and 63%, respectively. Recovery rate at 3 months for low, intermediate, and high risk children was 72%, 43% and 30%, respectively.
  
  
  CONCLUSIONS
  We present a simple rule to predict recovery from ITP at 3, 6, and 12 months from diagnosis. For prediction of resolution at 3 months, our rule was in agreement with the more complex, previously described Nordic score. Prediction of resolution of ITP may enable practitioners to better inform children and parents at the time of diagnosis, resulting in reduced anxiety and improved quality of life.
authors.affiliation: Department of Pediatric Hematology/Oncology, Hadassah Hebrew-University Hospital, Jerusalem, Israel.
authors.forename: Shoshana
authors.initials: S
authors.lastname: Revel-Vilk
authors.forename: Joanne
authors.initials: J
authors.lastname: Yacobovich
authors.forename: Shlomzion
authors.initials: S
authors.lastname: Frank
authors.forename: Tal
authors.initials: T
authors.lastname: Ben-Ami
authors.forename: Michal
authors.initials: M
authors.lastname: Yechieli
authors.forename: Vered
authors.initials: V
authors.lastname: Shkalim
authors.forename: Asaf
authors.initials: A
authors.lastname: Lebel
authors.forename: Rotem
authors.initials: R
authors.lastname: Semo-Oz
authors.forename: Hannah
authors.initials: H
authors.lastname: Tamary
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D005260:Female; D006470:Hemorrhage / Q000175:diagnosis*; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007223:Infant; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000175:diagnosis* / Q000628:therapy*; D011788:Quality of Life; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous
keywords: IGIV; ITP; Immune thrombocytopenia; immunoglobulin intravenous