Clin Pediatr Hematol Oncol.  2019 Oct;26(2):77-82. 10.15264/cpho.2019.26.2.77.

Clinical Features and Treatment Outcomes of Immune Thrombocytopenic Purpura in Infants: A Single Center Retrospective Study

Affiliations
  • 1Department of Pediatrics, Pusan National University School of Medicines, Yangsan, Korea. limyt@pusan.ac.kr

Abstract

BACKGROUND
Immune thrombocytopenic purpura (ITP) in children less than one year of age is less well characterized compared to ITP in toddlers and school-age children. Since children of different ages may have differing clinical courses, better delineation of the natural history of ITP in infants is needed.
METHODS
We retrospectively reviewed the admission records of 248 consecutive pediatric patients between 1 month and 15 years of age who were admitted and treated for acute ITP at Pusan National University Children's Hospital from 2009 through 2017. All patients less than 1 year of age were identified and enrolled in this study. We investigated their demographics, clinical features, laboratory examinations, response to treatment, and long-term outcomes and made a comparison to those of children aged 1 to 10 years of age.
RESULTS
Ninety nine infants were identified. Male to female ratio was highest in infants and decreased with age. Seventy nine (79.8%) of the 99 infant were found to be under 6 months old. The median platelet counts at diagnosis was 6×10⁹/L. Minor bleeding (bleeding score 0-2) was significantly dominant in infant compared to older subjects. Eighty two (96.5%) out of 85 patients achieved complete remission after initial intravenous immunoglobulin (IVIG) treatment. The relapse rate after initial CR was significantly lower than older ages (P=0.003). The platelet count after IVIG treatment in infant showed more rapid response compared to older subjects (P=0.04). Follow up information at 12 months was available for 70 infants. Chronic ITP at 12 month was seen less frequently in infants than in children 1 to 10 years of age (1.4% vs. 20.2%, P<0.001).
CONCLUSION
Infants with acute ITP respond more favorably to IVIG treatment and are less likely to develop chronic ITP compared to children 1 to 10 years of age.

Keyword

Immune thrombocytopenic purpura; Infants; Chronic

MeSH Terms

Busan
Child
Demography
Diagnosis
Female
Follow-Up Studies
Hemorrhage
Humans
Immunoglobulins
Immunoglobulins, Intravenous
Infant*
Male
Natural History
Platelet Count
Purpura, Thrombocytopenic, Idiopathic*
Recurrence
Retrospective Studies*
Immunoglobulins
Immunoglobulins, Intravenous
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