Clinical and laboratory findings in childhood immun thrombocytopenic purpura patients: retrospective evaluation

Acute immune (idiopathic) thrombocytopenic purpura (ITP), a self-limited and a benign condition, in children is the cause of the most frequent amegakaryocytic thrombocytopenia. It is characterized by the low platelet count (thrombocytopenia), spontaneous formation of purpura, petechiae, ecchymose and mucosal bleedings and it is also a disease which can be diagnosed with exclusion of other thrombocytopenia symptoms without having any clinical findings and can only be present with thrombocytopenia symptoms. However, the disease is important in aspect of severe organ bleedings and risk of becoming chronic. In this research we aimed at investigating the patients? stories, treatments, observations, laboratory findings and the effect of factors bringing the disease on becoming chronic.Total 151 patients, who were diagnosed with ITP and finished six months of observation time between January 2007 and December 2010, were evaluated. The patients? male/female ratio was 1/1.06. The average age was between 5.1±3.4. The 24.5 % of patients, diagnosed with acute ITP, became chronic. There was no climatically change on the patients with chronic ICP and whereas the infection rate was 69.1 % on the patients with acute ICP; the rate was 6 % on the patients with chronic ITP. The most encountered infection was upper respiratory tract infection (31 % of total patients). In aspect of distribution of symptoms, a difference was not found. The platelet count and age were found significantly low in acute group. 74.4 % of acute ITP patient?s platelet count was less than 10,000/ mm3. The number of serologic infections was found 15 (1 %) and Cytomegalovirus (CMV) was established. The numbers of acute cases were found higher in infant group. It was found that the patients with insidious complaints, applied to hospital became more chronic compared to the patients lack of insidious complaints. The 66 % of the patients, treated with methylprednisolone, responded to the treatment positive, partially-positive and negative in ratios of 64.3 %, 25.7 % and 1 % respectively. In the first treatment, the patients responded partially positive against steroid; the ratio of becoming chronic was found statistically significant (p=0,001). Additionally, in the acute ITP group the ratio of positive response against steroid was higher and this difference was found statistically significant (p<0,05).In terms of the given first treatment, on the patients having YDMP, IVIG, follow-up with no treatment , anti-D, IVIG+YDMP the ratio of becoming chronic were found as (% 27,7), (% 27,8), (% 17,6), (% 0), (% 8,3). The difference between becoming chronic and treatment was not statistically significant. In acute phase the response ratio follow-up with no treatment, YDMP and IVIG were found similar. The chronic symptomatic cases were followed by attack treatments and none of patients were made splenectomy. The patients did not have ıntracranial hemorrhage.The preference of economical and effective treatment methods for the ITP patients will prevent morbidity and mortality deaths relating to ITP.Keywords: ITP, Childhood , Retrospective Evaluation.