Korean J Pediatr.  2004 Apr;47(4):412-416.

Study on the Correlation between Clinical Classification according to Hemorrhagic Symptoms and Platelet Counts in Childhood Idiopathic Thrombocytopenic Purpura

• Bang HI
• Shin SR
• Choi DY

Abstract

PURPOSE
Idiopathic thrombocytopenic purpura(ITP) is a relatively common hematologic disease in children. The optimal strategy for treating ITP during childhood is a matter of controversy. In general, platelet count has been the primary, if not the sole measure, on which treatment decisions have been made and outcomes determined. In this study, we tried to find out the correlation between clinical classification of Bolton-Maggs and platelet counts in childhood ITP on initial diagnosis
METHODS
Seventy three patients with acute ITP in the Department of Pediatrics, Wonkwang University Hospital from June 1995 to December 2002, were enrolled. We retrospectively analyzed charts and classified our patients into four groups(no, mild, moderate, severe symptoms) according to Bolton-Maggs criteria.
RESULTS
The ratio of female to male is 0.82. The peak age incidence was two to five years(41%). It was prevalent in the spring in 23 cases(31%) and winter season in 23 cases(31%). Most common clinical symptoms at presentation were petechiae and purpura in 55 cases(75.1%). According to Bolton-Maggs criteria, our patients, classified into no symptoms, mild symptoms, moderate symptoms and severe symptoms were 9 cases(12%), 22 cases(29%), 23 cases(30%) and 19 cases(25%), respectively. Among the 47 patients with platelet counts below 20,000/mm3, those with no symptoms, mild symptoms, moderate symptoms and severe symptoms were:1 cases(0.02%), 13 cases(27%), 17 cases (36%) and 16 cases(34%) respectively. We found that this classification was highly correlated with the platelet counts on initial diagnosis(P=0.005).
CONCLUSION
There was a significant correlation between clinical classification of Bolton-Maggs and platelet counts. Therefore, this classification may be helpful in choosing the appropriate treatment options and evaluating the overall outcomes in childhood ITP.

Keyword

Idiopathic thrombocytopenic purpura; Clinical classification

MeSH Terms

Blood Platelets*
Child
Classification*
Diagnosis
Female
Hematologic Diseases
Humans
Incidence
Male
Pediatrics
Platelet Count*
Purpura
Purpura, Thrombocytopenic, Idiopathic*
Retrospective Studies
Seasons