Clinical and laboratory factors affecting chronicity in children diagnosed with immune thrombocytopenia

İmmun trombositopenili çocuklarda kronikleşmeyi etkileyen klinik ve laboratuvar faktörler

Abstract

AbstractPurpose: Immune thrombocytopenia (ITP) is one of the most common hematologic disorders in childhood.Approximately 20-25% of patients with newly diagnosed ITP become chronic. We aimed to investigate the riskfactors that may affect chronicity of ITP.Materials and methods: A total of 75 pediatric patients with ITP who were admitted to the Pediatric HematologyDepartment of Pamukkale University Faculty of Medicine Hospital between January 2013 and July 2018 wereincluded in the study. 17 of the 75 cases were excluded, because 13 of those had lack of data in the systemand 4 of those were persistent ITP. The patients’ characteristics such as clinical features, laboratory results,treatment requirements and type of treatment were retrospectively evaluated using the hospital's informationsystem.Results: 46 (79.3%) of the 58 patients with ITP were acute and 12 (20.7%) of those were chronic. The mean ageof the patients with acute ITP was 4±3.84 years, while the mean age of the patient with chronic ITP was 9.6±4.6years. Statistical analysis revealed that children with a diagnosis age greater than 10 years had a significantlyhigher rate of chronicity. The dominant season in acute cases was spring with 34.8%, while in chronic cases itwas summer with 50%. Acute cases were significantly higher in the spring season. 26 of 46 patients with acuteITP (56.5%) and 3 of 12 patients with chronic ITP (25%) were treated with IVIG firstly.Conclusion: We determined that in newly diagnosed patients with ITP who are older 10 years of age and nohistory of infection may have high risk of chronicity, while the patients diagnosed in the spring and administeredIVIG may have less chronicity.

Özet

Purpose: Immune thrombocytopenia (ITP) is one of the most common hematologic disorders in childhood. Approximately 20-25% of patients with newly diagnosed ITP become chronic. We aimed to investigate the risk factors that may affect chronicity of ITP. Materials and Methods: A total of 75 pediatric patients with ITP who were admitted to the Pediatric Hematology Department of Pamukkale University Faculty of Medicine Hospital between January 2013 and July 2018 were included in the study. The patients’ characteristics such as clinical features, laboratory results, treatment requirements and type of treatment were retrospectively evaluated using the hospital's information system. Results: 46 (79,3%) of the 58 patients with ITP were acute and 12 (20,7%) of those were chronic. The mean age of the patients with acute ITP were 4 ± 3,84 years, while the mean age of the patient with chronic ITP were 9,6 ± 4,6 years. Statistical analysis revealed that children with a diagnosis age greater than 10 years had a significantly higher rate of chronicity. The dominant season in acute cases was spring with 34,8%, while in chronic cases it was summer with 50%. Acute cases were significantly higher in the spring season. 26 of 46 patients with acute ITP (56,5%) and 3 of 12 patients with chronic ITP (25%) were treated with IVIG firstly. Conclusion: We determined that in newly diagnosed patients with ITP who are older 10 years of age and no history of infection may have high risk of chronicity, while the patients diagnosed in the spring and administered IVIG may have less chronicity.