Retrospective evaluation of patients with acute immune thrombocytopenic purpura and comparison between high-dose methylprednisolone and intravenous i̇mmunglobuli̇n treatments

Backgrounds and Aim: Immune thrombocytopenic purpura (ITP) that is one of the most frequent reasons of acquired thrombocytopenia in childhood. In current study, we aim to evaluate files of patients diagnosed with ITP for clinical presentation in application time and determine the affectivity of treatment choice, retrospectively. Patients and Method: The sample of study was consisting of patients who diagnosed with acute ITP and hospitalized in Inonu University Turgut Özal Medical Center Department of Pediatrics, Division of Hematology between January 2010 – August 2014. The record of patients files were analyzed, retrospectively. The clinical presentation and finding of patients in follow up after high dose methylprednisolon (HDMP) and Intravenous immunoglobulin (IVIG) were compared. Results: This study included 160 patients diagnosed with ITP. The mean age of patients was 6.15±4.29 years old. Male/female ratio was 1.31. The most common manifestations were petechiae and purpura (70%). At the time of application, 48.13% of the patients had history of infection within previous 1-4 weeks. Results of laboratory findings were; mean thrombocyte count was 12081±11912/mm3 and mean MPV value was 9.02±1.63 fL. Bone marrow aspiration was performed in the 96% of patients who were included in the study and increasing of megakaryocyte cell line was found in 126 patients (81.8%). There were no malignancy signs in our patients. 105 patients were treated with HDMP, and 55 patients were treated with IVIG. The patients' response to treatment were compared. The full respond was observed in 68,5% of the patients who were received HDMP and in 67,2% of the patients who were received IVIG on 10th day of treatment. There was no statistically significance between HDMP and IVIG groups. The rate of relaps and becoming chronic was found higher in the patients with bleeding time over 7 minutes. This finding was statistically significant. In addition, relapsing was developed in the 55 patients and 38 of these patients (69.1%) had became chronic.Conclusion: ITP is a disease frequently seen in childhood and 20-30 per cent of disease becomes chronic. No difference was found between HDMP and IVIG on becoming chronic and relapse in our study; In addition, rate of relapse and becoming chronic was found higher in patients with long bleeding time. Keywords: Immune thrombocytopenic purpura, child, intravenous immunglobulin, high-dose methylprednisolone