Variant clinical courses in children with immune thrombocytopenic purpura: Sixteen year experience of a single medical center.
OBJECTIVE
Immune thrombocytopenic purpura (ITP) is the most common cause of acquired thrombocytopenia in children. The objective of this study was to evaluate the presenting features, variation in the clinical courses, initial response rate to therapy, and long-term outcome in patients with ITP.


METHODS
Three hundred and fifty out of 491 newly diagnosed patients with ITP between the initial diagnosis ages of 6 months to 16 years were included in this retrospective, descriptive study. Patients with acute vs chronic ITP, acute vs recurrent ITP and chronic vs recurrent ITP were compared in terms of age at diagnosis, gender, initial platelet count, response rate to initial therapy, long-term outcome, and total duration of follow-up.


RESULTS
The clinical courses of the patients were determined as acute, chronic and recurrent in 63.8%, 29.1%, and 7.1%, respectively. Platelet count >20x109/L and initial diagnosis age >10 years were found to increase the probability of chronic outcome by at least two-fold.


CONCLUSIONS
It is concluded that ITP in childhood is a common disease with low morbidity and mortality. In addition to the acute and chronic form, a rare recurrent form, which accounts for about 4-7% of all ITP patients, should be considered.
Işın
I
Yaprak
Sağlık Bakanlığı Tepecik Eğitim ve Araştırma Hastanesi, Yenişehir, İzmir, Turkey Phone: +90 505 479 26 62 E-mail: batabay@ttmail.com.
Berna
B
Atabay
İkbal
İ
Durak
Meral
M
Türker
Haldun
H
Öniz
Esra
E
Arun Özer