Loading...
Please wait, while we are loading the content...
Similar Documents
Seventeen Years of Experience with Chronic Idlopathlc Thrombocytopenic Purpura in Childhood. Is Therapy Always Better?
| Content Provider | Scilit |
|---|---|
| Author | Aronis, Sophie Platokouki, Helen Mitsika, Angeliki Haidas, Stavros Constantopoulos, Andreas |
| Copyright Year | 1994 |
| Description | Journal: Pediatric hematology and oncology Between 1975 and 1992 450 children with idiopathic thrombocytopenic purpura (ITP) were diagnosed, and of those 100 (22%) developed the chronic form of the disease. Approximately half the patients with chronic ITP presented with mild to moderate hemorrhagic manifestations at the onset of purpura (30 cases) andlor later during the course of the disease (25 cases). The incidence of intracranial hemorrhage was 1 %, and the mortality rate due to overwhelming septicemia after splenectomy was also 1%. Overall one-third of the patients received no therapy; two-thirds of them went into spontaneous remission within 8 months to 8 years from the onset of ITP. Steroids given in conventional or high doses (51 cases) achieved a transient (if any) rise in platelet count, but in no case were steroids curative. Remission related to intravenous immune globulin (IVIG) therapy was noticed in 38.5% of the children (10 of 26) after variable courses. The response rate to splenectomy was 95.0%. Ultimately the long-term outcome in children with chronic ITP was as follows: remission, 58 cases (spontaneous, 30; after IVIG therapy, 10; after splenectomy, 18); hemostatic platelet values, 22 cases (spontaneous, 16; after IVIG, 5; after splenectomy, I). Thirteen children were lost in follow-up, and 7 remain thrombocytopenic but asymptomatic. These data indicate that chronic ITP in childhood runs a benign course in most cases and may remit with or without therapy euen several years from onset. Therefore, therapeutic intervention has to be individvalized, and splenectomy, which is not always safe, should be reserved for problematic cases that fail to respond to conventional therapeutic modalities. |
| Related Links | http://www.tandfonline.com/doi/pdf/10.3109/08880019409141687 |
| Ending Page | 498 |
| Page Count | 12 |
| Starting Page | 487 |
| ISSN | 08880018 |
| e-ISSN | 15210669 |
| DOI | 10.3109/08880019409141687 |
| Journal | Pediatric hematology and oncology |
| Issue Number | 5 |
| Volume Number | 11 |
| Language | English |
| Publisher | Informa UK Limited |
| Publisher Date | 1994-01-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Pediatric hematology and oncology Critical Care Medicine Chronic Idiopathic Thrombocytopenic Purpura Idiopathic Thrombocytopenic Purpura Idiopathic Thrombocytopenic Purpura Therapy |
| Content Type | Text |
| Subject | Hematology Pediatrics, Perinatology and Child Health Oncology |
