To determine the various causes of thrombocytopenia and its clinical correlation with bleeding in children and adolescents

Gyanesh Mishra, Rinu Dwivedi
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Abstract

Thrombocytopenia refers to a reduction in platelet count below 1,50,000/cumm. It is the most common cause of defective primary hemostasis that can lead to significant bleeding in children. It was a retrospective observational study conducted in a tertiary care hospital in Bhilai, chattisgarh between Augusts to December 2021. Data collection was done from Sept 2018-Sept 2019. The aim of present study was to determine the various causes of thrombocytopenia in children and adolescents and to correlate its severity with etiology and risk of bleeding. Total 112 patients were included from age group 1y-18 yrs. Out of total 112 patients 59 were males and 53 were females. 27 patients were 1-5 years of age, 30 patients were 6-12 years of age and55 were 13-18 years. The mean platelet count in my study was 68,340/cumm with a minimum of 4000/cumm. Bleeding was present in total 19 (16.9%) patients. The main bleeding manifestations were petechie or purpurae, epistaxis, ecchymosis, gastrointestinal bleed and others. Severity of thrombocytopenia correlates significantly with risk of bleeding (The p-value is 0.001**). The most common cause of thrombocytopenia in 69 patients with fever were infective and 43 patients without fever it was vitamin b12 deficiency. Severity of thrombocytopenia (p=0.0528) and bleeding (p=0.121) in patients with fever and without fever was not significant. Thrombocytopenia in pediatric and adolescent children is caused by both infective and non infective illness. It mainly presents with cutaneous bleeds and mucosal bleeds. Severity of thrombocytopenia is significantly correlated with bleeding.
确定儿童和青少年血小板减少的各种原因及其与出血的临床相关性
血小板减少症是指血小板计数低于 1,500,000 个/立方厘米。它是原发性止血功能缺陷最常见的原因,可导致儿童大量出血。这是一项回顾性观察研究,于 2021 年 8 月至 12 月期间在恰蒂斯加尔邦比莱的一家三级医院进行。数据收集时间为 2018 年 9 月至 2019 年 9 月。本研究旨在确定儿童和青少年血小板减少的各种原因,并将其严重程度与病因和出血风险相关联。研究共纳入112名1岁至18岁年龄组的患者。112 名患者中有 59 名男性和 53 名女性。27 名患者的年龄在 1-5 岁之间,30 名患者的年龄在 6-12 岁之间,55 名患者的年龄在 13-18 岁之间。在我的研究中,平均血小板计数为 68,340 个/立方厘米,最低为 4000 个/立方厘米。共有 19 名(16.9%)患者出现出血。主要出血表现为瘀点或紫癜、鼻衄、瘀斑、消化道出血等。血小板减少的严重程度与出血风险有明显相关性(P 值为 0.001**)。在 69 名发热患者中,最常见的血小板减少原因是感染,43 名无发热患者是维生素 b12 缺乏。发热和未发热患者血小板减少的严重程度(P=0.0528)和出血(P=0.121)无显著性差异。儿童和青少年血小板减少症由感染性和非感染性疾病引起。主要表现为皮肤出血和粘膜出血。血小板减少的严重程度与出血密切相关。
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