Clinical characteristics, management strategies, and outcomes of pediatric immune thrombocytopenic purpura: a five-year single-center experience.

OBJECTIVE

Immune thrombocytopenia (ITP), which is caused by immune-mediated platelet loss, is the most common cause of acquired thrombocytopenia in pediatric patients. In addition to evaluating treatment approaches and outcomes within a single-center cohort, this study aimed to evaluate the clinical and laboratory characteristics of juvenile ITP.

MATERIALS AND

METHODS

Out of 296 patients with thrombocytopenia, 135 children (ages 0-18) with acute ITP were included in this retrospective analysis. We reviewed clinical observations, laboratory results, therapeutic modalities, length of hospital stay, demographic data, and treatment outcomes.

RESULTS

Out of 296 patients, 161 (54.4%) had secondary thrombocytopenia, and 135 (45.6%) had ITP. 51.1% of the population was female, and the average age was 5.5±3.97 years. The most common symptoms were petechiae (40%) and ecchymosis (46.7%). 83.7% of patients received intravenous immunoglobulin (IVIG), resulting in a 91.2% response rate after a single dose. 14.1% of patients received corticosteroids, and most of them achieved platelet counts ≥30,000/mm³. In 15.6% of cases, bone marrow aspiration was performed prior to the start of steroid treatment. Splenectomy was required in 0.7% of cases, and rituximab in 1.5%. There was no discernible variation in the treatment response between the modalities (p=0.34). Secondary thrombocytopenia (n=161) was primarily caused by infection (64.5%), with Epstein-Barr virus being found in 3.7% of cases.

CONCLUSIONS

IVIG promoted rapid platelet recovery with high responder rates. Overall, the results were favorable, and there were no discernible differences between the treatment plans.