[Prognosis and treatment of idiopathic thrombocytopenic purpura in children].

The following conclusions can be drawn from the study of 55 cases of I.T.P. of childhood. 1. I.T.P. evolving more than 6 months must always be considered as chronic, the disease having in these cases few chances of recovery without splenectomy. After 6 months evolution, it is probably possible to establish a prognosis and a therapeutic approach with little risk of error. 2. Among the clinical and biological criteria noted at the onset of the disease, the intensity of thrombopenia alone is statistically different in acute and chronic I.T.P. Consequently, there are few criteria allowing the early recognition of evolution to chronic I.T.P. 3. The corticoids have no curative value in I.T.P. Prolonged corticotherapy is therefore useless in this disease. 4. As a palliative, the value of the corticoids can only be statisfactorily demonstrated in chronic I.T.P. Here it is certain in 6 cases on 16. 5. The value of corticoids for capillary resistance is evident, even in small doses. 6. Splenectomy must be considered in all cases of severe or corticodependant chronic I.T.P. Cure is obtained in most cases. 7. The contribution of immunosuppressive agents and in particular azathioprine, cannot be usefully assessed on the basis of the series studied. In the absence of decisive results, it would be worthwhile to evaluate this treatment by means of a greater number of clinical trials.