Evaluation of prevalence, clinical spectrum and outcome of acute ITP in children in a tertiary care centre in Odisha, India

Abstract

Background: Idiopathic thrombocytopenic purpura (ITP), also known as immune thrombocytopenic purpura is one of the commonest bleeding disorders encountered in children between the ages of 2 to 10 years affecting both sexes. The objectives of the study were to collect the prospectively data including age, gender, bleeding type, platelet count and other laboratory tests, treatments, responses to treatment and outcomes in children with acute ITP from 1month to 14 years of age over a period of two years.Methods: The present study was conducted in the Department of Paediatrics Shrirama Chandra Bhanj, Medical College and Hospital and Sardar Vallabhbhai Patel Post Graduate Institute of Paediatrics, Cuttack during the period October 2011-Septmber 2013.Results: Total 36 cases of hospitalized acute ITP patients were studied out of 29200 cases. Prevalence of acute ITP was found to be 12.3 per 10,000 of all hospitalized children above 1 month. Male children outnumbered female children by Ratio 1.2. Past history of URTI was present in 78% of cases. Petechaie/purpura was the universal presenting features followed by Oral / Gum bleeding in 67% of cases. 8% of patient experienced clinical bleeding requiring blood transfusion and platelet transfusion. Mean duration of Hospital stay was 6.34 days. Maximum number of Patients (69%) had complete recovery and 14% each had persistent and chronic course.Conclusions: ITP is a common pediatrics disease presenting at any age with low morbidity and mortality. Most children with acute ITP recover in weeks to months. A long-term hospital based prospective study is suggested to know any significant risk factor in patient presenting with acute ITP.

Outcome of Immune Thrombocytopenic Purpura In a Tertiary Care Centre

“…All these patients, who received combination therapy showed a response after initial treatment but 12 months follow up revealed that only 40% achieved complete remission. We observed two factors; age above 10 years and female gender which play significant role in developing chronic ITP, which is similar to the results of other study 18 . In our study, among 103 patients, 34 (33%) patients developed chronic disease and all patients undergo bone marrow study before defining as a chronic disease, while in another study, 36 (14%) patients showed chronic disease 19 .…”

Clinical features and outcome in paediatric newly diagnosed immune thrombocytopenic purpura in a tertiary care centre

“…Similarly in another study by Mushtaq et al, out of 95 children, only 5 (5.3%) patients developed chronic ITP. 9 , 15 The high rate of chronicity might be due to complicated initial presentation, as suggested by Heitink-Pollé KM et al, female gender, older age at presentation, absence of preceding infection or vaccination were identified as risk factors for developing chronic ITP. 16 However this warrants further investigation.…”

Thrombocytopenia in Children: A Large Prospective Study on Clinical Manifestations, Seasonal Variation, Etiology, and Outcome

“…Seasonal variations in the incidence of thrombocytopenia may also point toward etiology, as tropical infections leading to thrombocytopenia are more common during the rainy season in India. [6][7][8][9] A systematic approach should be followed to evaluate a child with thrombocytopenia, as it may provide an important clue to different diseases. The involvement of other cell lines, which is seen on the peripheral blood smear, also provides clues.…”

“…The involvement of other cell lines, which is seen on the peripheral blood smear, also provides clues. [6][7][8] The principal management goal in all patients who have thrombocytopenia is to maintain a safe platelet count to prevent significant bleeding. [8][9][10][11] In developing countries, as a result of decreased awareness and insufficient healthcare institutions, diagnoses of these disorders are often made late, resulting in increased mortality and morbidity.…”