Demographic data, natural history, and prognostic factors of idiopathic thrombocytopenic purpura in children: A multicentered study from Argentina

Donato, Hugo; Picón, Armando; Martínez, Mònica; Rapetti, María Cristina; Rosso, Amadeo; Gómez, Sergio; Rossi, Nestor; Bacciedoni, Viviana; Schvartzman, Gabriel; Riccheri, Cecilia; Costa, Alejandra; Santo, Juan Di

doi:10.1002/pbc.21872

Cited by 78 publications

(86 citation statements)

References 34 publications

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“…Ruggiero et al [6] reported 5 (41.6%) out of 12 cITP patients approaching complete remission within 15-90 months. Donato et al [8] reported a 32.9% rate of spontaneous remission in 325 nonsplenectomized children with cITP between 6 months to 11 years; 44.9% approached remission 6-12 months from diagnosis. In Jayabose et al's [7] series of 62 cITP patients, a 56% spontaneous remission rate was reported.…”

Section: Discussionmentioning

confidence: 99%

“…It is likely that all pediatricians will encounter children with ITP at some time in their practice. There are still many questions to be answered regarding the natural progress of the clinical forms and the prediction of chronic or recurrent outcome, response to treatment and ultimate outcome [1][2][3][4][5][6][7][8][9][10].…”

Section: Discussionmentioning

confidence: 99%

“…The majority of the children with cITP have mild bleeding episodes not requiring treatment despite persistent thrombocytopenia. In addition, rates of spontaneous recovery of 30-60% have been reported many years after initial diagnosis [6][7][8]. In our cohort, 102 patients with cITP were evaluated in non-remission and late-remission subgroups.…”

Section: Discussionmentioning

confidence: 99%

“…All of these authors recommended delay or omission of surgical treatment and reservation of splenectomy for patients with severe symptoms and non-responders. Imbach et al [14] and Donato et al [8] also reported that the cut-off value to define cITP should be changed from 6 months to 12 months. Our observation, too, showed that the cut-off point of cITP should be changed to 12 months since immune thrombocytopenia could persist beyond 6 months and could recover spontaneously in months to years.…”

Section: Discussionmentioning

confidence: 99%

“…Children with chronic ITP (cITP) manifest variable clinical features and management is controversial [1][2][3][4][5]. Response rate to treatment is usually low in cITP; however, in some studies, high rates of spontaneous remission have been reported [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

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Variant clinical courses in children with immune thrombocytopenic purpura: Sixteen year experience of a single medical center

Yaprak¹,

Atabay²,

Durak³

et al. 2010

Turk J Hematol

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Objective: Immune thrombocytopenic purpura (ITP) is the most common cause of acquired thrombocytopenia in children. The objective of this study was to evaluate the presenting features, variation in the clinical courses, initial response rate to therapy, and long-term outcome in patients with ITP. Materials and Methods: Three hundred and fifty out of 491 newly diagnosed patients with ITP between the initial diagnosis ages of 6 months to 16 years were included in this retrospective, descriptive study. Patients with acute vs chronic ITP, acute vs recurrent ITP and chronic vs recurrent ITP were compared in terms of age at diagnosis, gender, initial platelet count, response rate to initial therapy, long-term outcome, and total duration of follow-up. Results: The clinical courses of the patients were determined as acute, chronic and recurrent in 63.8%, 29.1%, and 7.1%, respectively. Platelet count >20x10 9 /L and initial diagnosis age >10 years were found to increase the probability of chronic outcome by at least two-fold. Conclusion: It is concluded that ITP in childhood is a common disease with low morbidity and mortality. In addition to the acute and chronic form, a rare recurrent form, which accounts for about 4-7% of all ITP patients, should be considered. (Turk J Hematol 2010; 27: 147-55) Key words: Immune thrombocytopenic purpura, children, clinical course, chronic, recurrent, outcome

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Variant clinical courses in children with immune thrombocytopenic purpura: Sixteen year experience of a single medical center

Yaprak¹,

Atabay²,

Durak³

et al. 2010

Turk J Hematol

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Influence of the American Society of Hematology Guidelines on the Management of Newly Diagnosed Childhood Immune Thrombocytopenia

Schultz

Mitra

Schapira³

et al. 2014

JAMA Pediatr

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We demonstrated a significant practice change in the management of newly diagnosed ITP at a pediatric care tertiary care hospital in the United States surrounding revision of the ASH management guidelines for childhood ITP. Our experience supports adoption of observation alone for a proportion of patients with newly diagnosed childhood ITP. This form of management did not lead to an increase in later treatment or an increase in delayed bleeding symptoms.

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SNP array and phenotype correlation shows that FLI1 deletion per se is not responsible for thrombocytopenia development in Jacobsen syndrome

Trková

Bečvářová

Hynek

et al. 2012

American J of Med Genetics Pt A

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Jacobsen syndrome (JBS) is a rare chromosomal disorder caused by terminal deletion of the long arm of chromosome 11. We report on four prenatally diagnosed patients with JBS with variable prenatal and postnatal phenotypes and 11q deletions of varying sizes. Precise characterization of the deleted region in three patients was performed by SNP arrays. The severity of both the prenatal and postnatal phenotypes did not correlate with the size of the haploinsufficient region. Despite the large difference in the deletion size (nearly 6 Mb), both of the live-born patients had similar phenotypes corresponding to JBS. However, one of the most prominent features of JBS, thrombocytopenia, was only present in the live-born boy. The girl, who had a significantly longer deletion spanning all four genes suspected of being causative of JBS-related thrombocytopenia (FLI1, ETS1, NFRKB, and JAM3), did not manifest a platelet phenotype. Therefore, our findings do not support the traditional view of deletion size correlation in JBS or the causative role of FLI1, ETS1, NFRKB, and JAM3 deletion per se for the development of disease-related thrombocytopenia.

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Demographic data, natural history, and prognostic factors of idiopathic thrombocytopenic purpura in children: A multicentered study from Argentina

Cited by 78 publications

References 34 publications

Variant clinical courses in children with immune thrombocytopenic purpura: Sixteen year experience of a single medical center

Variant clinical courses in children with immune thrombocytopenic purpura: Sixteen year experience of a single medical center

Influence of the American Society of Hematology Guidelines on the Management of Newly Diagnosed Childhood Immune Thrombocytopenia

SNP array and phenotype correlation shows that FLI1 deletion per se is not responsible for thrombocytopenia development in Jacobsen syndrome

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