Immune Thrombocytopenia Purpura in Children in Lebanon: Prevalence, Treatment Modalities, and Clinical Outcomes in a Retrospective Study

Hassan Khalife, F. Abdel-Sater, Zaynab Fatfat, H. Khalife, Kawthar H. Sharaf Al-Deen, Hala Khalife
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Abstract

Background: Immune thrombocytopenia purpura (ITP) is one of the most common autoimmune diseases in children characterized by a decreased number of circulating platelets combined with impaired platelet production. There is limited literature data on the prevalence and treatment modalities, and outcome of ITP in children from Lebanon. Methods: We retrospectively reviewed the demographic and clinical data of 59 patients aged 0–18 years diagnosed with ITP between January 2007 and April 2016 in different hospitals in Beirut and the south of Lebanon. Results: ITP patients represented 2.5% of the total number of children admitted to these hospitals during this period. Among the ITP children, 55.93% were male and 44.07% were female. The greatest number of ITP children were in the 1–4 year group, followed by the 5–9 year group. As for the clinical course of the disease, 40.68% of the ITP children presented acute ITP, whereas 59.32% presented chronic ITP. Among the different therapeutic approaches adopted to treat these ITP children, intravenous immunoglobulin was the most commonly used, followed by steroids, a combination of these both agents, cyclosporine, and splenectomy. Interestingly, these therapeutic modalities induced a statistically significant increase in the patients’ platelet count. In addition, the clinical course of ITP was not significantly associated with each of the age group, the platelet count at diagnosis, and gender of patients. Conclusion:This study showed the prevalence of ITP among children from Lebanon, where more than half of ITP children presented a chronic disease. Further studies are needed to evaluate additional predictors of chronic ITP among children from Lebanon and help medical providers make informed decisions about treating childhood ITP. Doi: 10.28991/SciMedJ-2022-04-04-02 Full Text: PDF
黎巴嫩儿童免疫性血小板减少性紫癜:一项回顾性研究的患病率、治疗方式和临床结果
背景:免疫性血小板减少性紫癜(ITP)是儿童最常见的自身免疫性疾病之一,其特征是循环血小板数量减少并伴有血小板生成受损。关于黎巴嫩儿童ITP的患病率、治疗方式和结果的文献数据有限。方法:我们回顾性回顾了2007年1月至2016年4月期间在贝鲁特和黎巴嫩南部不同医院诊断为ITP的59名0–18岁患者的人口统计学和临床数据。结果:ITP患者占同期入住这些医院的儿童总数的2.5%。ITP患儿中男性占55.93%,女性占44.07%。ITP儿童数量最多的是1-4岁组,其次是5-9岁组。就疾病的临床病程而言,40.68%的ITP儿童表现为急性ITP,而59.32%的儿童表现为慢性ITP。在治疗这些ITP儿童的不同治疗方法中,静脉注射免疫球蛋白是最常用的,其次是类固醇、这两种药物的组合、环孢菌素和脾切除术。有趣的是,这些治疗方式诱导了患者血小板计数的统计学显著增加。此外,ITP的临床病程与每个年龄组、诊断时的血小板计数和患者的性别没有显著相关性。结论:本研究显示了黎巴嫩儿童ITP的患病率,黎巴嫩一半以上的ITP儿童患有慢性病。需要进一步的研究来评估黎巴嫩儿童慢性ITP的其他预测因素,并帮助医疗提供者在治疗儿童ITP方面做出明智的决定。Doi:10.28991/SciMedJ-2022-04-04-02全文:PDF
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