Clinical and Laboratory Characteristics of Children with Idiopathic Thrombocytopenic Purpura

Abstract The most common primary autoimmune thrombocytopenia in children is immune (idiopathic) thrombocytopenic purpura (ITP) with extremely variable clinical manifestations, from asymptomatic forms to life-threatening bleeding. The latest classification divides ITP into acute (ndITP), persistent (pITP) and chronic form (cITP). This research was designed as a retrospective–prospective study which analyzed basic demographic, clinical and routine laboratory parameters relevant to ITP. There was slight predominance of girls in all forms of ITP. Children of preschool age dominated in ndITP, while adolescents in cITP group. pITP and cITP patients predominantly presented as asymptomatic or with mild haemorrhagic signs, while ndITP patients had moderate or severe bleeding. Skin hematomas are the most common sites of bleeding. Mostly ndITP patients did not have other diseases, while 30% of cITP patient have other autoimmune disease. No hepatosplenomegaly was observed in ndITP patient, but almost a quarter of the cITP patients had splenomegaly. The mean value of platelet count is significantly higher in chronic groups compared to ndITP group, against mean platelet volume values that show an inverse correlation. More than half ndITP patients achieved complete remission after intravenous immunoglobulin and additional 30% experienced spontaneous remission during the persistent disease period and about one third of cITP patients required therapy. The spleen is dominant or only organ of platelet sequestration in cITP patients.