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. 1995 Feb;72(2):125–128. doi: 10.1136/adc.72.2.125

Chronic idiopathic thrombocytopenic purpura: incidence, treatment, and outcome.

M M Reid 1
PMCID: PMC1511010  PMID: 7702373

Abstract

In order to determine incidence, outcome, trends in management and natural history, data on 92 children with chronic idiopathic thrombocytopenic purpura (ITP), comprising 66 from a single centre's experience between 1950 and 1980 and all 26 presenting from a defined population between 1984 and 1994, have been analysed. Its incidence, calculated from the population based group, is 0.46/10(5) children per year. Twenty nine of 34 (85%) remitted after splenectomy. Short initial histories predicted response to splenectomy. Splenectomy was offered only half as frequently in the last 10 years as in the 30 year, single centre group of children. Most (39 cases) of those not offered or successfully treated by splenectomy recovered spontaneously. The predicted spontaneous remission rate in 85 with adequate follow up data is 61% after 15 years. No other form of active treatment was of lasting benefit. No death solely attributable to chronic ITP occurred. The high spontaneous recovery rate, low mortality, and generally benign outcome may encourage a less interventionist approach to management.

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Selected References

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  1. Aronis S., Platokouki H., Mitsika A., Haidas S., Constantopoulos A. Seventeen years of experience with chronic idiopathic thrombocytopenic purpura in childhood. Is therapy always better? Pediatr Hematol Oncol. 1994 Sep-Oct;11(5):487–498. doi: 10.3109/08880019409141687. [DOI] [PubMed] [Google Scholar]
  2. Chessells J. Chronic idiopathic thrombocytopenic purpura: primum non nocere. Arch Dis Child. 1989 Sep;64(9):1326–1328. doi: 10.1136/adc.64.9.1326. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Choi S. I., McClure P. D. Idiopathic thrombocytopenic purpura in childhood. Can Med Assoc J. 1967 Sep 9;97(11):562–568. [PMC free article] [PubMed] [Google Scholar]
  4. Eden O. B., Lilleyman J. S. Guidelines for management of idiopathic thrombocytopenic purpura. The British Paediatric Haematology Group. Arch Dis Child. 1992 Aug;67(8):1056–1058. doi: 10.1136/adc.67.8.1056. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Hoyle C., Darbyshire P., Eden O. B. Idiopathic thrombocytopenia in childhood. Edinburgh experience 1962-82. Scott Med J. 1986 Jul;31(3):174–179. [PubMed] [Google Scholar]
  6. Lammi A. T., Lovric V. A. Idiopathic thrombocytopenic purpura: an epidemiologic study. J Pediatr. 1973 Jul;83(1):31–36. doi: 10.1016/s0022-3476(73)80308-7. [DOI] [PubMed] [Google Scholar]
  7. Lilleyman J. S. Chronic idiopathic thrombocytopenic purpura: the pediatrician's dilemma. Pediatr Hematol Oncol. 1990;7(2):115–118. doi: 10.3109/08880019009033379. [DOI] [PubMed] [Google Scholar]
  8. Lilleyman J. S. Definitions and dogma in childhood idiopathic thrombocytopenic purpura. Pediatr Hematol Oncol. 1993 Oct-Dec;10(4):xi–xiv. doi: 10.3109/08880019309029504. [DOI] [PubMed] [Google Scholar]
  9. Lilleyman J. S. Management of childhood idiopathic thrombocytopenic purpura. Br J Haematol. 1983 May;54(1):11–14. doi: 10.1111/j.1365-2141.1983.tb02062.x. [DOI] [PubMed] [Google Scholar]
  10. Ramos M. E., Newman A. J., Gross S. Chronic thrombocytopenia in childhood. J Pediatr. 1978 Apr;92(4):584–586. doi: 10.1016/s0022-3476(78)80293-5. [DOI] [PubMed] [Google Scholar]
  11. Reid M. M., Saunders P. W., Fenwick J. D., Walker W. Splenunculectomy in thrombocytopenic purpura. Arch Dis Child. 1986 Feb;61(2):192–194. doi: 10.1136/adc.61.2.192. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Reid M. M. Splenectomy and chronic ITP in children. Br J Haematol. 1992 Oct;82(2):481–482. doi: 10.1111/j.1365-2141.1992.tb06455.x. [DOI] [PubMed] [Google Scholar]
  13. Tait R. C., Evans D. I. Late spontaneous recovery of chronic thrombocytopenia. Arch Dis Child. 1993 May;68(5):680–681. doi: 10.1136/adc.68.5.680. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Walker R. W., Walker W. Idiopathic thrombocytopenia, initial illness and long term follow up. Arch Dis Child. 1984 Apr;59(4):316–322. doi: 10.1136/adc.59.4.316. [DOI] [PMC free article] [PubMed] [Google Scholar]

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