P380 Therapeutic management of immune thrombocytopenia – single centre experience

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Abstract

Background

The Immune thrombocytopenia (ITP) is one of the most frequent haematological disorders and it is considered to be the result of an immune-mediated process. Some cases resolve within few weeks, but the majority of them need treatment.

Aims

The analysis of evolution of children with ITP in one unit.

Methods

The medical records of 83 patients diagnosed with ITP were reviewed focusing especially on treatment strategies. They were diagnosed and treated between January 2012-August 2016 in the IV-th Clinic of Saint Mary’s Hospital for Children, Iasi.

Results

47 out of 83 patients are female and 40 are male. First line therapy was used as it follows: 24 patients received intravenous immunoglobulins and 59 received corticosteroid therapy. Second-line therapy consisted in Azathioprine and Rituximab. 9 patients received Azathioprine and 3 received Rituximab.

Results

In this study group we tried to categorise the patients according to the terminology established by the International Working Group (2009) in: newly diagnosed, persistent ITP and chronic ITP. Thus, we found that 9 patients evolved towards persistent form and 14 developed chronic ITP. In the group of chronic ITP patients, 6 are diagnosed with refractory form of the disease.

Conclusion

All our patients received treatment, even if the international guidelines are recommending the ‘watchful waiting’ in the cases that don’t show risk of severe bleeding. Usually is very hard to convince the parents that the illness is, in most of the cases, self-limited. Therefore, in our clinic the management of new cases of ITP needs a better standardisation in relation with the severity of bleeding and not with the number of platelets.

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