Evaluating the Treatment Indices of Immunologic Thrombocytopenic Purpura in Pediatric Patients

Iranian Journal of Pediatric Hematology & Oncology Pub Date : 2024-01-09 DOI:10.18502/ijpho.v14i1.14662

Mahdieh Saberi, Mehrdad Shekiba, Alireza Jenabzade, Hadi Zare-Zardini

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Abstract

Background: Immunologic Thrombocytopenic Purpura (ITP) is considered as one of the common diseases among children. The aim of this study is evaluating the treatment indices of ITP in pediatric patients. Materials and Methods: In this observational follow-up study, 123 ITP patients were assessed in term of medical history, physical examination, and laboratory tests based on the type of treatment. Results: Among 123 ITP patients, 70 (56.9%) were female and 53 (43.1%) were male with mean age of 4 years. Considering the platelet count of > 20,000, 115 (93.6%), 4 (3.3%) were treated in less than a month (acute) and 1-6 months (sub-acute). Thirty two patients (26%) did not reach the normal platelet count in 6 months (chronic). IVG, steroid, RhoGAM, steroid+ IVIG, RhoGAM + IVIG, RhoGAM+steroid+IVIG therapy was done in 10.6, 15.4, 2.4, 41.5, 4.1, and 26, respectively. Three patients did not receive any medication. There was no significant relationship between the onset of clinical symptoms and the onset of treatment based on 20,000 platelet count; however, regarding the platelet count of 150000, the relationship was statistically significant. The frequency of ITP was higher in females. There was no report on Intra-cerebral hemorrhage (ICH). In addition, 11 patients (8.9%) were provided with splenectomy. The treatment with combinational therapy of RhoGAM and IVIG was regarded as the highest treatment rate. In addition, the highest length of hospotalization based on initial treatment belonged to steroid treatment followed by the combinational therapy of steroid and IVIG. The patients receiving IVIG were the ones with the highest cost for the first 24 hours of treatment, and regarding the later hospitalization, the patients treated with steroid and combinational therapy of steroid+IVIG had to pay the highest medical expenses. Conclusion: No significant relationship between the symptoms, platelet count, and the type of treatment.

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评估儿科免疫性血小板减少性紫癜的治疗指标

背景：免疫性血小板减少性紫癜（ITP免疫性血小板减少性紫癜（ITP）是儿童常见疾病之一。本研究旨在评估儿童患者的 ITP 治疗指数。材料和方法：在这项观察性随访研究中，根据治疗类型对 123 名 ITP 患者进行了病史、体格检查和实验室检查评估。结果在 123 名 ITP 患者中，70 名（56.9%）为女性，53 名（43.1%）为男性，平均年龄为 4 岁。血小板计数大于 20,000 的患者有 115 人（占 93.6%），4 人（占 3.3%）的治疗时间少于一个月（急性期）和 1-6 个月（亚急性期）。有 32 名患者（26%）在 6 个月内（慢性期）血小板计数未达到正常值。接受 IVG、类固醇、RhoGAM、类固醇+IVIG、RhoGAM+IVIG、RhoGAM+类固醇+IVIG 治疗的患者分别为 10.6、15.4、2.4、41.5、4.1 和 26 人。3名患者未接受任何药物治疗。血小板计数为 2 万时，临床症状的出现与治疗的开始之间没有明显关系；但血小板计数为 15 万时，两者之间的关系具有统计学意义。女性患 ITP 的频率较高。没有关于脑内出血（ICH）的报告。此外，有 11 名患者（8.9%）接受了脾脏切除术。RhoGAM和IVIG联合疗法的治疗率最高。此外，初始治疗中，类固醇治疗的住院时间最长，其次是类固醇和 IVIG 的联合治疗。接受 IVIG 治疗的患者在最初 24 小时的治疗费用最高，而在之后的住院治疗中，接受类固醇治疗和类固醇+IVIG 联合治疗的患者需要支付的医疗费用最高。结论症状、血小板计数与治疗类型之间无明显关系。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Iranian Journal of Pediatric Hematology & Oncology

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