Platelets level response after three days therapy in children with acute Immune Thrombocytopenic Purpura (ITP): a 10 years’ experience at the tertiary hospital

Abstract

Background: Immune thrombocytopenic purpura (ITP) is the most common cause of thrombocytopenia in children that characterized by isolated thrombocytopenia that vary in bleeding manifestations. The onset of disease is sudden and a self-limiting condition that requires treatment when clinically significant bleed occurs. A treatment goal is to increase platelet level above safety level and reduce the risk of severe bleeding. This study aims to evaluate the platelets level increment after three days treatment among children with acute ITP.Methods: An analytic retrospective cross-sectional study was conducted in Haematology-Oncology Paediatric Division Sanglah General Hospital, Bali, Indonesia from October 2008 to October 2018 in ITP patients. Diagnosis of ITP was evaluated based on the clinical manifestation and laboratory finding. Oral corticosteroid medication with dosage 2 mg/kg/day or 4 mg/kg/day with or without platelets transfusion were enrolled in this study from medical records. Data were analyzed using SPSS version 20 for Windows.Results: There were 93 children met the inclusion criteria and included in this study. A median platelets level at admission was 6.81(1-86.8) x 109/L. Majority symptoms of children with ITP in our tertiary care centre presented with mild to moderate clinical bleeding symptoms. Only 5.6% children with platelets level below 10x109/L had intracranial bleeding. Median platelets level was 31(2.47-382) x 109/l and there was a significant platelets level increment after three days of therapy (P<0.05).Conclusion: The platelets level increment significantly in children with acute ITP after three days of therapy.

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“…Knowledge of the patient's phenotype can guide RBC transfusion strategies [16]. Thrombocytopenia is a common finding in AIHA during pregnancy, and it is often accompanied by immune thrombocytopenia (ITP) in 0.8-3.7% of cases, a condition known as Evans Syndrome [17,18]. In this patient, the thrombocytopenia could potentially be attributed to gestational thrombocytopenia, as the platelet count increased during the treatment course, as depicted in Figure 2.…”

Management of pregnant women with Refractory Immune Thrombocytopenia Purpura (ITP) receiving eltrombopag therapy at Sanjiwani Hospital, Gianyar, Indonesia

“…Immune Thrombocytopenic Purpura (ITP) is caused by the circulation of antiplatelet antibodies, namely Platelet-Associated immunoglobulins (PAIg), which bind to glycoproteins (GP) llb/ llla complex or GP1b/IX complex or other glycoprotein complexes. 6 These antibody-coated platelets are destroyed by tissue macrophages which are mainly located in the spleen. 6,7 Decreased platelet production occurs in acute and chronic ITP because autoantibodies to platelet glycoproteins interfere with megakaryocytic maturation.…”