Idiopathic Thrombocytopenic Purpura in Egyptian Children
| Autor: | Mohsen Gadallah, K.A. Tolba, Fawzia H. Ibrahim, M.S. El-Alfy, A. S. Khalifa |
|---|---|
| Rok vydání: | 1993 |
| Předmět: |
Male
Vincristine medicine.medical_specialty Pediatrics Adolescent medicine.medical_treatment Treatment outcome Splenectomy Methylprednisolone immune system diseases Prednisone hemic and lymphatic diseases medicine Humans Child Purpura Thrombocytopenic Idiopathic business.industry Immunoglobulins Intravenous Infant Hematology General Medicine medicine.disease Thrombocytopenic purpura Surgery Purpura Treatment Outcome Child Preschool Egypt Female medicine.symptom business medicine.drug |
| Zdroj: | Acta Haematologica. 90:125-129 |
| ISSN: | 1421-9662 0001-5792 |
| DOI: | 10.1159/000204392 |
| Popis: | 350 patients with idiopathic thrombocytopenic purpura (ITP) aged 2/12-15 years (mean 6.3 +/- 2.7) were followed up during the period January 1st, 1975 to March 31, 1992. They constituted 40% of cases with hemorrhagic diathesis attending the Hematology/Oncology Clinic, Children's Hospital, Ain Shams University (relative frequency of 37.4/100.000 of the general Out-Patient Clinic in the same hospital). These patients presented with acute (71.4%), chronic (22.9%) and recurrent (5.7%) forms. The age of presentation was younger in acute ITP. In the recurrent form there was significant female predominance. Most cases of acute ITP (66%) presented in winter and spring, with a positive history of preceding viral illness in 50% in contrast to 10% in chronic form. Four chronic ITP cases developed lupus erythematosus; all were females9 years. As regards therapy, acute ITP cases with initial platelet count (PC)10 x 10(9)/l were randomized to receive either high-dose methyl prednisolone (HDMP) 10 mg/kg/day for 5 days i.v. (n = 10) or intravenous immunoglobulin (IVIG) 0.4 g/kg/day for 5 days (n = 10) or conventional-dose prednisone (CDP) 2 mg/kg/day 4 weeks p.o. (n = 10). A dramatic response was noticed in the first two groups. In chronic ITP, (n = 80) CDP induced complete response (CR) in 30% and partial response (PR) in 20%; 50% were nonresponders. Twenty-four refractory ITP with persistent PCor = 20 x 10(9)/l received second-line therapy: vincristine 1.5 mg/m2/week i.v. 4 doses (n = 4) with no clinical or hematological improvement. IVIG 0.4 g/kg/day for 5 days (n = 8) with sustained CR only in 2 patients (25%) and PR in 2 patients (25%). Splenectomy was performed (n = 12) with CR in 50%; out of them, 2 patients had shown no improvement on prior IVIG therapy. In conclusion, ITP is a benign condition with no fatality reported, but it could run a chronic refractory course. |
| Databáze: | OpenAIRE |
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