Clinical features and treatment outcomes in children with idiopathic thrombocytopenic purpura: A single center’s experience

Objective: Childhood idiopathic thrombocytopenic purpura (ITP) is a common disorder. The objective of this study is to review presenting features and response to therapy of ITP treated at a single pediatric medical center. Method: A retrospective chart review was made for all children (ages birth–18 years) diagnosed with ITP and treated at the Sivas Cumhuriyet University Hospital. Files of children with ITP were retrospectively reviewed. There were 156 children with newly diagnosed ITP and 36 children with chronic ITP. The diagnosis of ITP was based on the exclusion of other causes of thrombocytopenia by detailed history, physical examination, complete blood count with blood smear and bone marrow examination. Results: There was no significant difference in median charges for the intravenous immunoglobulin (IVIG), prednisolone (IV) and mega-dose methylprednisolone (MDMP) groups for the initial treatment of ITP. History of antecedent infection and vaccination were present in 44.2% and 8.3% of the patients, respectively. At diagnosis, 76.4% of the patients had a platelet count of <10,000/μl but only 11.1% had major bleedings. Intracranial hemorrhage was seen in two patients (1%) with a mortality rate of 0.05%. 5.1% developed chronic ITP. Conclusions: These data show that mode of treatment has no effect on the clinical course and prognosis of childhood ITP. However, the IVIG was significantly more expensive than steroids