[Auto-immune idiopathic thrombocytopenic purpura in children. Apropos of 100 cases].

Abstract

The authors report the results of a retrospective study concerning 100 children with immune thrombocytopenic purpura who were referred between January 1981 and January 1991. Twenty-seven children had a chronic evolution with a significantly high risk: girls aged 9 years or more, hospitalization longer than 10 days, or patients with a history of frequent ecchymoses. The risk of haemorrhage was highest at the early phase of the disease and when the platelet count was below 25 G/l. The need for laboratory tests has been controversial and the authors suggest a simplified list of tests after having demonstrated the limited value of tests attempting to document the prepurpuric infectious episode or associated disease. The number of responders was comparable in the group receiving corticosteroids (78%) and in that receiving intravenous immunoglobulins (76.5%), as was the number of complete remissions in both groups (40.4% and 50%, respectively). 20.5% of the patients receiving intravenous immunoglobulins experienced a chronic evolution versus 29.8% in the group receiving corticosteroids (no significant difference). Seventeen patients underwent splenectomy with excellent result, particularly in one child who underwent urgent splenectomy because of intracranial haemorrhage.