期刊名称：International Journal of Early Childhood Special Education
电子版ISSN：1308-5581
出版年度：2022
卷号：14
期号：3
页码：1056-1070
DOI：10.9756/INT-JECSE/V14I3.130
语种：English
出版社：International Journal of Early Childhood Special Education
摘要：Background: Immune thrombocytopenia (ITP) is an autoimmune disorder characterized by isolated thrombocytopenia(low platelet count (<100 ×109/L)) in absence of other secondary causes. The disease is caused by increased platelet destruction by humoral or cellular immune mechanisms as well as inappropriate platelet production in the bone marrow.The study aimed to demonstrate and analyzed the pattern of clinical presentation, laboratory findings, response todifferent protocols of treatment and outcome of the three categories of ITP patients (acute, persistent and chronic) inhematology and oncology unit of pediatric and clinical pathology department of Zagazig University Hospitals. Methods: The study includes 48 patients categorized into 3 groups (acute, persistent and chronic). Acute group includes 19 patients.Persistant group includes 11 patients. Chronic group includes 18 patients.Patients were subjected to full history taking, along with complete physical examination including; site and shape of bleeding and routine laboratory investigations including; complete blood count, ANA, antiDNase ,thyroid function test,h.pylori antigen in stool, level of immunoglobulin and bone marrow aspiration if indicated. Results: This study show no significant relation between age, sex, clinical presentation, risk factors (vaccination, viralinfection and h.pylori infection) and laboratory results and outcome, except initial platelet number at diagnosis .This study showed that initial platelet count has statistically significant difference in the course of the disease. A significant higher median platelet count at diagnosis for patients who developed chronic ITP and vice versa and can be considered predictive factor for chronicity. Also no significant relation between outcome and protocol of management except use of eltrombopag which show more increase in platelet number in the three groups Conclusion: ITP in children is a nonthreatening and self-limited disease. Most of them show complete recovery. The most common presentation in ITP is cutaneous bleeding. There is no significant relation between history of recent vaccination, infection or H.pylori infection and outcome of the disease. Initial platelet count has statistically significant difference in the outcome of the disease. A significant higher median platelet count at diagnosis found in patients who developed chronic ITP. Although there are many therapeutic options for treatment of immune thrombocytopenia, there is no single therapeutic agent satisfactory for all patients. Use of eltrombopag was the most effective therapy for increasing platelet number especially in chronic or persistent patients in our center.
