Idiopathic thrombocytopenic purpura in children

Jelena Roganović

Abstract


Idiopathic thrombocytopenic purpura (ITP) is the most commonacquired bleeding disorder in childhood. ITP is characterizedby a low circulating platelet count caused principallyby destruction of antibody-coated platelets in the reticuloendothelialsystem. It can be classified into two major forms,acute and chronic. Acute ITP is usually a benign self-limitingcondition with a high probability of spontaneous recovery.Rates of 80% complete remission can be achieved regardlessof the treatment. Persistence of thrombocytopenia for morethan 6 months defines the chronic form of the disorder, and isseen in approximately 20% of children. Children with chronicITP also have a good prognosis, with up to 80% remissionsover a period of years following diagnosis. The variability ofclinical course makes the decision of whether and how to treatdifficult. Most children with ITP have mild bleeding symptomsand require no therapy. The commonly used regimensinclude corticosteroids and intravenous immunoglobulins. Sofar, there is no evidence that initial therapy can prevent majorbleeding or a chronic course of the disease. ITP in childhoodremains a disorder with many unsolved questions regardingpathophysiology, diagnostic approach and therapeutic decisions.Large prospective clinical trials with long-term followupare needed to define which subgroup of children with ITPshould be treated with platelet-enhancing therapy.

Keywords


Idiopathic thrombocytopenic purpura, Child

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References


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