Retrospective analysis of 78 children with chronic idiopathic thrombocytopenic purpura: Follow-up from 1976 to 1996


Yetgin S., Olcay L., Ozsoylu S., Hicsonmez G., Gurgey A., Tuncer A.

PEDIATRIC HEMATOLOGY AND ONCOLOGY, no.5, pp.399-412, 1997 (SCI-Expanded) identifier identifier

Abstract

In this retrospective study of 20 years, 78 children with chronic idiopathic thrombocytopenic purpura (ITP) were analyzed. Patients were followed for 1-17 years (median 2.7 years). Every application that required therapy was accepted as an ''attack.'' Seventy-eight patients received therapy in 236 attacks. Immediate platelet responses to high-dose methylprednisolone (HDMP), prednisone, and splenectomy were 69.3% (in 53 patients), 48.3% (in 35 patients), and 84.6% (in 29 patients) of attacks, respectively. Because 31 patients were lost to follow-up, the rate of remission was calculated on the basis of 47 patients. The remission rates for patients who underwent remission spontaneously, after steroid therapy, and after splenectomy were 29.78, 6.38, and 14.89%, respectively. Of 78 adolescent patients, 11.5% had intracranial hemorrhage (ICH), being after splenectomy. One patient died because of ICH. These data indicate that chronic ITP is still a serious problem during adolescence and splenectomy still seems to be a current choice of therapy.