Prognostic clinical and laboratory parameters in children with primary immune thrombocytopenic purpura

Abstract EN

Immune thrombocytopenia (1TP) is an autoimmune disease characterized by a decreased platelet count (less than 100 x 109/L) due to destruction of antibody- sensitized platelets in the reticuloendothelial system (RES).

[TP in children has a varied course and according to duration is distinguished as newly diagnosed (<3 months), persistent (3-12), and chronic (>12) types.

Several studies have evaluated the prognostic factors for the progression of the disease.

We aimed in this prospective study to identify prognostic parameters for the disease in 44 children in the period from October 2015 to November 2016 at Mansoura University Children Hospital (MUCH)& Mansoura Health Insurance Hospital (MHIH).

Information regarding age, gender, preceding infection, bleeding type, duration of symptoms and platelet count at diagnosis, treatment type, and antiglycoprotien antibodies was recorded.

This study is designed to determine, the prognostic factors that could predict the disease course at diagnosi, estimate the presence of antibodies at disease onset and evaluate whether the antibody pattern at disease onset can predict the course of the disease, i.e.

acute or chronic and evaluate treatment types and outcome in children with ITP From the studied cases 33 children had newly diagnosed and 11 chronic disease.

Chronic ITP children had gradual initiation of the disease, higher initial platelet count compared to newly diagnosed group.

Cutaneous bleeding was found in all cases.

None of the children exhibited life threatening bleeding.

Primary immune thrombocytopenic purpura (ITP) in childhood is usually a self- limiting disorder lasting a few weeks or months, but in approximately 25% of the children, the condition becomes chronic, defined as thrombocytopenia (platelet count less than 150x 109/ L) persisting for longer than 12 months from the onset of illness.

In conclusion, even though ITP in children usually has a self- limited course, with rare serious bleeding complications, the chronic form of the disease is characterized by different predictive parameters, which can be used in clinical practice.