GULHANE MEDICAL JOURNAL 2005 , Vol 47 , Issue 4
Retrospective analysis of our cases with acute immune thrombocytopenic purpura
A.Avni Atay1, Vural Kesik2, Göknur Candemir2, A.Emin Kürekçi1, S.Ümit Sarıcı2, Okan Özcan2, Erdal Gökçay2
1GATA Çocuk Hematolojisi BD.
2GATA Çocuk Saılığı ve Hastalıkları AD.
Fifty five patients with acute immune thrombocytopenic purpura who were diagnosed at the Division of Pediatric Hematology, Department of Pediatrics of Gülhane Military Medical Academy were retrospectively analyzed, and complaints, symptoms, findings of physical examination, laboratory data at the time of diagnosis and our treatment modalities were reviewed. Of all the patients, 25 and 30 were female and male, retrospectively, and the mean age was 5.0±3.7 years (2.5 months to 16 years). The disease was diagnosed at autumn, fall, winter and summer in 18.2%, 21.8%, 23.6% and 36.4% of the cases, respectively. The role of a previous infection and vaccination took role in the etiology in 38% and 5.5% of the cases, respectively. Of the clinical signs and symptoms, dermatologic findings such as petechia, purpura or ecchymosis were detected in 51 (92.7%) patients, epistaxis in 18 (32.7%) patients, guiac positive blood in stool in six (10.9%) patients, microscopic hematuria in 13 (23.6%) patients, and oral mucosal and gingival bleeding in 19 (34.5%) patients. Intracranial bleeding and death were not detected. The pretreatment platelet levels were between 6000/mm3 and 100000/mm3 (median 27000/mm3). Ten of the 24 patients who underwent bone marrow aspiration and 13 of the 31 patients who did not undergo bone marrow aspiration received treatment. Twenty one patients received oral prednisolon, intravenous high dose prednisolon or intravenous immunoglobulin, and two patients received Helicobacter pylori eradication treatment only. Splenectomy was performed in one patient who passed to the chronic stage. Keywords : Acute immune thrombocytopenic purpura, child, etiology, treatment