Contributions
Abstract: PB1729
Type: Publication Only
Session title: Platelet disorders
Background
Immune thrombocytopenia (ITP) during childhood is usually characterized by acute onset of thrombocytopenia with around 75% of children having spontaneous remission within 6 months. Most children experience only mild bleeding in the form of bruising and Petechiae, with severe bleeding being rare even in children with persistent disease
Aims
To study demography, clinical, laboratory and treatment options of patients who were newly registered cases of immune thrombocytopenia referred to Children Welfare Teaching Hospital, Medical City, Baghdad.
Methods
A retro-prospective descriptive study was done on a newly diagnosed patients with ITP who were referred to Children’s Welfare Teaching Hospital (CWTH) / Medical City / Baghdad from January 1, 2019 to April 30, 2020. The period of data collection and follow up started in September 2019 till December 2020
Results
A total of 107 patients were identified as having a presumptive newly diagnosed Immune Thrombocytopenia. Seven patients were excluded after being diagnosed as secondary ITP or other causes of thrombocytopenia during observation period. The mean age was 5.6 years (range 3 months-13.5 years). There were 56 (52.3%) boys, with a M:F ratio was 1.09:1. The mean duration of symptoms is 62 days. Sixty-four (59.8%) patients were managed as an outpatient only.
Sole cutaneous bleeding was reported in 55 (51.4%) patients while wet purpura was the leading cause of mucosal bleeding occur in 25 (23.3%) patients followed by epistaxis in 24 (22.4%) patients. According to grading, grade I/II was seen in 55(51.4%). The mean platelet’s count was 15.7x109/L, Platelet’s count of <30 x109/L in 92 (86%) patients.
Seventy-eight patients (72.9%) reached CWTH without receiving any treatment while 29 (27.1%) patients received treatment elsewhere. The total number of patients kept under watchful waiting strategy was 44 (41.1%).
The mean and median platelets count at both time of diagnosis and time of last contact in the observation group were higher than that of the treatment group (24&19 vs 9.9&7 x 109/L at time of diagnosis; 210.6&246 vs 204.8&214 at time of last contact). There was significant statistical correlation between each group and classification of grading (P value 0.0001).
Comparing severe thrombocytopenia (platelet’s count < 30 x 109/L) and bleeding score among 2 groups; there was significant statistical correlation between bleeding grade at time of diagnosis and at time of last contact (P value 0.004).
Conclusion
The result of this study confirms the result of last year study in the same center which encourages the successful management of ITP by observation only and support the consensus that ITP is a benign and self-limited condition for the majority of affected children. The incidence on intracranial bleeding was 0.9%. The study observations support the emerging trend toward reserving drug therapy for ITP patients with major bleeding manifestations or troublesome impairment of quality of life.
Keyword(s): Bleeding, Children, Platelet, Treatment
Abstract: PB1729
Type: Publication Only
Session title: Platelet disorders
Background
Immune thrombocytopenia (ITP) during childhood is usually characterized by acute onset of thrombocytopenia with around 75% of children having spontaneous remission within 6 months. Most children experience only mild bleeding in the form of bruising and Petechiae, with severe bleeding being rare even in children with persistent disease
Aims
To study demography, clinical, laboratory and treatment options of patients who were newly registered cases of immune thrombocytopenia referred to Children Welfare Teaching Hospital, Medical City, Baghdad.
Methods
A retro-prospective descriptive study was done on a newly diagnosed patients with ITP who were referred to Children’s Welfare Teaching Hospital (CWTH) / Medical City / Baghdad from January 1, 2019 to April 30, 2020. The period of data collection and follow up started in September 2019 till December 2020
Results
A total of 107 patients were identified as having a presumptive newly diagnosed Immune Thrombocytopenia. Seven patients were excluded after being diagnosed as secondary ITP or other causes of thrombocytopenia during observation period. The mean age was 5.6 years (range 3 months-13.5 years). There were 56 (52.3%) boys, with a M:F ratio was 1.09:1. The mean duration of symptoms is 62 days. Sixty-four (59.8%) patients were managed as an outpatient only.
Sole cutaneous bleeding was reported in 55 (51.4%) patients while wet purpura was the leading cause of mucosal bleeding occur in 25 (23.3%) patients followed by epistaxis in 24 (22.4%) patients. According to grading, grade I/II was seen in 55(51.4%). The mean platelet’s count was 15.7x109/L, Platelet’s count of <30 x109/L in 92 (86%) patients.
Seventy-eight patients (72.9%) reached CWTH without receiving any treatment while 29 (27.1%) patients received treatment elsewhere. The total number of patients kept under watchful waiting strategy was 44 (41.1%).
The mean and median platelets count at both time of diagnosis and time of last contact in the observation group were higher than that of the treatment group (24&19 vs 9.9&7 x 109/L at time of diagnosis; 210.6&246 vs 204.8&214 at time of last contact). There was significant statistical correlation between each group and classification of grading (P value 0.0001).
Comparing severe thrombocytopenia (platelet’s count < 30 x 109/L) and bleeding score among 2 groups; there was significant statistical correlation between bleeding grade at time of diagnosis and at time of last contact (P value 0.004).
Conclusion
The result of this study confirms the result of last year study in the same center which encourages the successful management of ITP by observation only and support the consensus that ITP is a benign and self-limited condition for the majority of affected children. The incidence on intracranial bleeding was 0.9%. The study observations support the emerging trend toward reserving drug therapy for ITP patients with major bleeding manifestations or troublesome impairment of quality of life.
Keyword(s): Bleeding, Children, Platelet, Treatment