AI Summary & Key Takeaways
AI InsightSplenectomy was performed in one patient who passed to the chronic stage.
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Abstract
Retrospective analysis of our cases with acute immune thrombocytopenic purpura Fifty five patients with acute immune thrombocytopenic purpura who were diagnosed at the Division of Pediatric Hematology, Department of Pediatrics of Gülhane Military Medical Academy were retrospectively analyzed, and complaints, symptoms, findings of physical examination, laboratory data at the time of diagnosis and our treatment modalities were reviewed. Of all the patients, 25 and 30 were female and male, retrospectively, and the mean age was 5.0±3.7 years (2.5 months to 16 years). The disease was diagnosed at autumn, fall, winter and summer in 18.2%, 21.8%, 23.6% and 36.4% of the cases, respectively. The role of a previous infection and vaccination took role in the etiology in 38% and 5.5% of the cases, respectively. Of the clinical signs and symptoms, dermatologic findings such as petechia, purpura or ecchymosis were detected in 51 (92.7%) patients, epistaxis in 18 (32.7%) patients, guiac positive blood in stool in six (10.9%) patients, microscopic hematuria in 13 (23.6%) patients, and oral mucosal and gingival bleeding in 19 (34.5%) patients. Intracranial bleeding and death were not detected. The pretreatment platelet levels were between 6000/mm3 and 100000/mm3 (median 27000/mm3). Ten of the 24 patients who underwent bone marrow aspiration and 13 of the 31 patients who did not undergo bone marrow aspiration received treatment. Twenty one patients received oral prednisolon, intravenous high dose prednisolon or intravenous immunoglobulin, and two patients received Helicobacter pylori eradication treatment only. Splenectomy was performed in one patient who passed to the chronic stage.
Özet
Bu çalışmada GATA Çocuk Hematolojisi polikliniğinde akut immün trombositopenik purpura tanısı alan 55 hasta retrospektif olarak değerlendirilmiş ve bu olguların tanı esnasındaki yakınmaları, fizik inceleme ve laboratuvar bulguları ile tedavi yaklaşımlarımız gözden geçirilmiştir. Olguların 25'i kız, 30'u erkek, ortalama yaşları ise 5.0±3.7 yıl (2.5 ay-16 yaş) idi. Hastalığın ilkbaharda %18.2, sonbaharda %21.8, kışın %23.6 ve yazın %36.4 oranında görüldüğü tespit edildi. Etiyolojide geçirilmiş infeksiyon %38, aşılama hikayesinin de %5.5 oranında rol aldığı görüldü. Klinik bulgulardan peteşi, purpura veya ekimoz gibi cilt bulguları 51 olguda (%92.7), epistaksis 18 olguda (%32.7), dışkıda gizli kanama altı olguda (%10.9), mikroskopik hematüri 13 olguda (%23.6) ve oral mukoza ile diş eti kanamaları 19 olguda (%34.5) görüldü. İntrakraniyal kanama ve ölüm saptanmadı. Olguların başlangıç trombosit değerleri 6000/mm3 ile 100000/mm3 arasında değişmekteydi (ortanca 27000/mm3). Kemik iliği aspirasyonu yapılan 24 olgunun 10'una, aspirasyon yapılmayan 31 olgunun 13'üne tedavi verildi. Yirmi bir olguda oral prednizolon, intravenöz yüksek doz prednizolon, intravenöz immünglobülin ve iki olguda da sadece Helicobacter pylori eradikasyon tedavisi düzenlendi. Kronikleşen bir olgumuza splenektomi uygulandı.