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A prospective comparative study of 2540 infants
and children with newly diagnosed idiopathic thrombocytopenic purpura
(ITP) from the Intercontinental Childhood ITP Study Group.
J Pediatr. 2003 Nov;143(5):605-8.
Kühne T, Buchanan GR, Zimmerman S, Michaels LA, Kohan R, Berchtold W, Imbach P, Intercontinental Childhood ITP Study Group ; Intercontinental Childhood ITP Study Group.
Division of Oncology/Hematology, University Children's Hospital, Basel, Switzerland.
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OBJECTIVE:
To analyze prospectively the impact of age at diagnosis in childhood
idiopathic thrombocytopenic purpura (ITP). STUDY DESIGN: International
registry from June 1997 to May 2001, with analysis of data from
baseline and 6-month-follow-up questionnaires. RESULTS: Data from 2540
patients were analyzed, including 203 infants (7.6%), 1860 children
> or =1 to <10 years of age (69.1%), and 477 children and
adolescents between > or =10 and <16 years of age (17.7%).
The
mean platelet count at diagnosis was similar in all three groups, as
was the percentage of patients with initial platelet count
<20x10(9)/L. The male/female ratio was highest in infants and
decreased with age (P=.009). Immunoglobulin therapy was used more often
in infants and corticosteroids in patients > or =10 years of age.
Follow-up information at 6 months was available for 1742 children
(68.6%). Chronic ITP was seen less frequently in infants (23.1%) than
in children >10 years of age (47.3%, P<.0001). Intracranial
hemorrhage occurred in 3 of 1742 children during the first 6 months
after the diagnosis of ITP. CONCLUSIONS: Pediatric patients with ITP
from infancy to adolescence exhibit heterogeneity in clinical,
demographic, and treatment factors.
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