Clinical Courses and Outcome of Newly Diagnosed Immune Thrombocytopenia in Infants / 임상소아혈액종양

BACKGROUND: Infants with immune thrombocytopenia (ITP) are at increased risk of high risk bleeding and vaccination-associated ITP. Infants with ITP respond favorably to treatment and are less likely to develop chronic ITP compared to older children. However the characteristics of this entity in infants have rarely been analyzed. We investigated the clinical characteristics and response to treatment of newly diagnosed ITP in infants under 1 year of age. METHODS: We retrospectively reviewed the medical records of newly diagnosed ITP infants between 1 month to 11 months of age at Chonbuk National University Hospital from 2002 to 2017. The demographics, complete blood count, absolute lymphocyte count (ALC), absolute neutrophil count, vaccination history, upper respiratory infection, viral study (cytomegalovirus) and treatment of patients with ITP were reviewed. RESULTS: A total of 85 patients satisfied the criteria for newly diagnosed ITP. Of these patients, 83 were in complete remission, 6 were in persistent remission, and 2 progressed to chronic ITP. As a result of the study, 57 patients (67%) were male. 71 patients (83.5%) were secondary ITP. Among secondary ITP, vaccination related ITP was the most common cause with 60 patients (84.5%). The mean at diagnosis was 4.3±3.2 month. There was no statistically significant difference in ALC between the time of diagnosis and treatment. Hemoglobin was 10.8 g/dL at diagnosis and increased significantly to 12.3 g/dL after treatment. CONCLUSION: Ninety-seven percent of ITP patients diagnosed under 1 year of age were in remission.

Primary Polydipsia in Children: Two Case Reports

Primary polydipsia (PP) is marked by an increase in thirst, and most often presents in patients with psychiatric illnesses. Although uncommon in children, we experienced cases of PP in a 15-month-old boy and a 5-year-old girl. Both were admitted to the hospital with symptoms of polydipsia and polyuria that appeared 1–3 months before admission. Brain magnetic resonance imaging in both patients was normal. A water restriction test was performed after hospitalization and showed normal results. The symptoms improved after the parents were instructed to implement water-intake restriction for 2 weeks. Our report provides useful information for the treatment of PP in children.