[Idiopathic thrombocytopenic purpura. Study of 61 cases]

ABSTRACT

Idiopathic thrombocytopenic purpura [ITP] represented the most frequent cause of children's thrombocytopenia. Until our days universal management of ITP does not exist. We performed retrospective and then prospective study of 61 children admitted for ITP during 15 years. The aim of the study was to precise the epidemiological, clinical and therapeutic profiles and propose management algorithm. The incidence of ITP was 0.34 per cent. The mean age was 6 years with male predominance. Initial thrombocytopenia was inferior than 10.000/mm3 in 44,2 per cent of cases. Spontaneous recovering was noted in 17 cases. Oral prednisone therapy with 2mg/kg/day during 21 to 35 days and 4mg/kg/day during 4 days was performed respectively in 21 and 19 cases. Intravenous immunoglobulin and methylprednisolone pulse therapy was performed respectively in 17 and 5 cases. Splenectomy was successfully performed in 3 cases. Chronic ITP was noted in 13 cases. Acute ITP without hemorrhagic syndrome should be treated in first stage with oral prednisone at 4mg/kg/day during 4 days. In case of failure, a second cure may be prescribed. If not we return to intravenous immunoglobulin