AI Summary & Key Takeaways
AI InsightIf thrombocytopenia was severe and resistant, splenectomy was the best alternative therapy in chronic ITP and remission rate was 78%.
📌 3 Key Takeaways
Abstract
Idiopathic thrombocytopenic purpura (ITP) is the most common acquired bleeding disorder in childhood. Spontaneous remissions are usual but in 10-20% of cases the disease become chronic. Short- term high dose methylprednisolone (HDMP) or intravenous immunoglobuline (IVIG) or combined therapy is administered in severe cases. In this study, between 1988 and 1996, 108 children diagnosed and followed up idiopathic thrombocytopenic purpura were analysed retrospectively. Fiftynine (54.6%) of the children were acute ITP, 44 (40.8%) were chronic ITP, 5 (4.6%) were recurrent ITP. Remission was achieved in 7.3 days with HDMP treatment, 4.2 days with IVIG and 6.2 days with combined (HDMP+IVIG) treatment in acute ITP. There were no significant difference between treatment modalities and remission days. Although HDMP and IVIG have been used in chronic ITP response was transient and unsatisfactory, and remission rates were 16% and 13% respectively. If thrombocytopenia was severe and resistant, splenectomy was the best alternative therapy in chronic ITP and remission rate was 78%.
Özet
idiyopatik trombositopenik purpura (ITP) çocukluk çağında en sık görülen akkiz kanama hastalığıdır. Genellikle spontan remisyon olmakla birlikte olguların %10-20'sinde hastalık kronikleşir. Kısa süreli yüksek doz metil prednizolon (YDMP), intravenöz immunoglobulin (IV/G) veya kombine tedavi aktif kanamalı olgularda kullanılır. Bu çalışmada 1988-1996 yılları arasında ITP tanısı alan ve izlenen 108 olgu retrospektif olarak incelendi. Olguların %54.6'sı akut ITP, %40.8'i kronik I'TP, %4.6'sı rekürren I'TP idi. Olgular remisyona YDMP ile 7.3 günde, IVlG ile 4.2 günde, kombine tedavi ile 6.2 günde girdi. Tedavi modeli ile remisyona girme süresi arasında önemli fark yoktu. Kronik iTP'de gerekli durumlarda YDMP ve İVlG kullanılmasına rağmen cevap geçici ve yetersiz olup remisyona girme oranları sırasıyla %16 ve %13 idi. Trombositopeninin şiddetli ve dirençli olduğu kronik ITP'H olgularda splenektomi en iyi tedavi şekli olup remisyon oranı %78 idi.