Immune thrombocytopenia in children: An observation a study inTunisia.

Immunevthrombocytopenic purpura(ITP)in children is a heterogeneous condition,varying in Clinical features, need for treatment and outcome. Our study aimed to describe epidemiological, clinical and therapeutic data of ITP inourcenter.This study included patients aged between 2 and 18 years old,diagnosed with ITP duringa17-years period in the pediatric hematology department at Aziza Othmana hospital,in Tunisia. Thirty-one children were followed up for ITP during the study's period,with a mean age of 15 years old [2-18]. Eighteen patients(58%)had mild bleeding while 4patients(13%)had severe hemorrhage. Buchanan score was higherthan2 in12patients (39%).The median platelet count was 14 G/L[1-85]. No etiology was identified in any of them. Eighteen patients were treated by oral corticosteroids(1mg/kg),2 by intravenous corticosteroids and 4 by oral corticosteroids (4 mg/kg)in association with intravenous immunoglobulins.Therest of patients, were not in indication for medical treatment.Among the treated patients,63%had a complete response, 29% a partial response and8%were cortico-resistant. Seven patients were corticosteroid-dependent.Twelve patients relapsed(46%)with a median delay of relapseof31months [11-106].As a second line treatment, 10 patients were treated by corticosteroids(1 mg/kg), just one patient had a splenectomy.Management of ITP in children,represents are al challenge. Although corticosteroids and immunoglobulinare effective as first line therapy,the high rate of relapse high lights theneed to improve new therapeutic strategies for second-line treatment. 22.