Clinical outcome of childhood immune thrombocytopenia: Experience from a single tertiary center in Turkey

INTRODUCTION: Immune Thrombocytopenic Purpura (ITP) is the most common hemorrhagic disease in children. Intracranial hemorrhage is the most severe complication requiring the administration of treatment for immune thrombocytopenic purpura. The present study aims to determine the clinical outcomes and factors affecting remission in childhood ITP.
METHODS: Method. The study included 503 children diagnosed with ITP in a Pediatric Hematology Polyclinic. Patient files and electronic registries were accessed retrospectively to obtain sociodemographic details, and diagnostic and therapeutic characteristics.
RESULTS: Results. Among all the cases, 446 (88.7%) were in remission. When the first treatments applied in cases with remission were evaluated, 190 (83.4%) patients had IVIG, 25 (56.8%) IVIG + pulse steroid, 34 (79%) pulse steroid, 7 (58%) IVIG + low dose steroid and 20 (83%) had low dose steroid treatment. Four cases developed intracranial hemorrhage during follow-up. The remission rate was significantly higher among the cases with low MPV values, high platelet counts and sedimentation values in the blood test at diagnosis (p<0.05). The responses to pulse steroids, low-dose steroids and IVG for the initial treatment at diagnosis were similar, with none showing statistical superiority over any of the others (p>0.05).
DISCUSSION AND CONCLUSION: Conclusion. This study features the largest single-center study in pediatric ITP. The frequency of remission was higher in the ITP-diagnosed cases who were male, who were diagnosed at a younger age, who had no epistaxis on admission, who had a history of URTI, and who had a high platelet count and sedimentation value and a lower MPV value at diagnosis.