Entscheidungshilfen zur Therapie der idiopathischen thrombozytopenischen Purpura (ITP) im Kindesalter

Gadner, Helmut; Er, Grümayer; Oa, Haas

doi:10.1055/s-2008-1033876

Cited by 3 publications

(2 citation statements)

References 19 publications

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“…Finally, only splenectomy had a beneficial long-Iasting effect on platelet counts in our patients. The postoperative rise of Iflatelets seems to be the best prognostic parameter to identify patients with a good chance of obtaining complete remission (6). Accordingly, patient L. T. with a postoperative platelet count of less than 500 x 10 9 /1 achieved a partial remission, while both other patients with platelet counts of more than 500 x 10 9 /1 have normal platelet counts after 17 and 21 months, respectively.…”

Section: Discussionmentioning

confidence: 99%

ITP in Childhood: Difficulties in the Individual Treatment

Grümayer¹,

Haas²,

Panzer³

et al. 1986

Klin Padiatr

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To date, immunoglobulin preparations and corticosteroids are the most important therapeutic principles in idiopathic thrombocytopenic purpura (ITP). Initial treatment with high-dose immunoglobulins (HD-IgG) as well as the following prednisone therapy, however, were only of short lasting success in three children with newly diagnosed ITP. Recurrent bleeding tendency tempted to combine both drugs. A desired longterm elevation of platelet counts, however, was not achieved. Administration of Anti-Rho (D) to two of the patients was also disappointing. Splenectomy which could not be postponed any longer has already led to 17 and 21 months lasting remissions in 2 patients, respectively. The third patient who required monthly single doses of HD-IgG for 6 months after surgery, is in a partial remission since 27 months now. All types of drug administration--alone, consecutive or even combined--must be considered to defer splenectomy. As experienced in our patients, however, splenectomy still seems to be justified in case even such individually adapted therapeutic approaches fail.

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Section: Discussionmentioning

confidence: 99%

ITP in Childhood: Difficulties in the Individual Treatment

Grümayer¹,

Haas²,

Panzer³

et al. 1986

Klin Padiatr

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“…Eine Kombination einzelner Krankeitsmerkmale kann jedoch prognostische Hinweise liefern: Auftreten zwischen dem 2. und 5. Lebensjahr, Assoziation mit Virusinfekten und Thrombozytenzahlen unter 20 Gil sprechen für eine akute ITP; Alter über 10 Jahren, schleichender, nicht infektassoziierter Beginn und Plättchenzahlen zwischen 50 und 75 G/I weisen auf eine chronische ITP hin (12,39). Antikörper gegen Plättchenglykoprotein (11 blIII a. I b/IX) finden sich häufiger bei der akuten als bei der chronischen ITP (5).…”

Section: Introductionunclassified

Die Anwendung von Corticosteroiden und Immunglobulinen bei der akuten und der chronischen Immunthrombozytopenie im Kindesalter

Höcker-Schulz¹,

Elstner²,

Pawlosky³

et al. 1997

Klin Padiatr

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In 80% of children suffering from immune thrombocytopenic purpura, the disease is a self-limited process. Established therapeutic measures are commonly used to effect symptomatic relief. The foremost of these is the administration of immunoglobulins and corticosteroids. A total of 113 children and adolescents with immune thrombocytopenic purpura were examined retrospectively in this study. Of these, 48%, did not require any therapy, 37% were treated with high-dose immunoglobulin, and 15% with prednisolone as first-line treatment of extensive purpura of the skin and the mucous membrane. The time until the thrombocyte count reached 100 G/l was shorter in the treated group than in the one that was not treated (4.5 and 6.0 versus 21 days). 71% of all patients achieved remission in six month. In 29% the disease took a chronic course. Of 33 children with chronic therapy-dependent disease, 7 were splenectomised successfully. Seven further patients continue to live with thrombocyte counts below 20 G/l, of which 4 suffer from recurrent bleeding episodes. In patients with acute and chronic immune thrombocytopenic purpura, the aim of treatment is to prevent potentially fatal bleeding. Patients with thrombocyte counts below 20 G/l are high-risk patients. Nevertheless, even in this group, the therapy should be decided clinically according to bleeding tendency. Ideally, the therapy should result in a quick increase of thrombocyte counts whilst causing minimum side effects. Of the various established treatment modalities, high-dose immunoglobulin and high-dose prednisolone best fulfil these requirements.

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Thrombozytopenien — Differentialdiagnose und Therapie

Göbel¹

1992

Akute Blutung Als Notfall Im Kindesalter

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Entscheidungshilfen zur Therapie der idiopathischen thrombozytopenischen Purpura (ITP) im Kindesalter

Cited by 3 publications

References 19 publications

ITP in Childhood: Difficulties in the Individual Treatment

ITP in Childhood: Difficulties in the Individual Treatment

Die Anwendung von Corticosteroiden und Immunglobulinen bei der akuten und der chronischen Immunthrombozytopenie im Kindesalter

Thrombozytopenien — Differentialdiagnose und Therapie

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