Primary immune thrombocytopenia in childhood: a regional study in the south of Tunisia

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Published Jun 4, 2014
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Vol. 92 No. 3 (2014): Issue Mar 2014

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L. Sfaihi
O. Kassar
M. Medhaffar
T. Kamoun
S. Hadiji
H. Aloulou
H. Bellaj
N. Ajmi
I. Chabchoub
M. Elloumi
M. Hachicha

Abstract

Background: the primary immune thrombocytopenia (ITP) in children has a favorable evolution in most of cases.

aim: describe the epidemiological and therapeutic data and the outcome of primary immune thrombocytopenia in our patients and propose a treatment plan to standardize the management of this disease in our region.

methods: We conducted a retrospective study of 140 cases of primary immune thrombocytopenia collected in department of pediatrics and hematology of Hedi Chaker hospital during a period of 15 years. Patients who had a platelet count ≤ 20 000 and / or mucosal or troublesome lifestyle hemorrhage were treated.

results: The mean age was 6 years 7months with extremes varying from 3 months to 15 years. The bleeding manifestations were dominated by cutaneous bleeding in the form of petechiae or bruise  (100%). Epistaxis and gingivorragia were noted in 32,9% and 25,7% of the cases respectively. The most of patient were treated with corticosteroids (79%). Intravenous immunoglobulin was associated with corticosteroids in 7%. An acute ITP occurred in 94 cases (67%)
and a chronic ITP in 30 cases (21%).

Conclusion: In the recently diagnosed ITP, the response delay under association Intravenous immunoglobulin and corticoids is shorter than that of corticoids alone, but the high cost of Intravenous immunoglobulin associated with their immediate side effects compels us to recommend corticoids as a first line of treatment.

Keywords:

primary immune thrombocytopenia; children; corticosteroids; intravenous immunoglobulin

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