A population-based, multisite cohort study of the predictors of chronic idiopathic thrombocytopenic purpura in children
- PMID: 18310170
- DOI: 10.1542/peds.2007-1129
A population-based, multisite cohort study of the predictors of chronic idiopathic thrombocytopenic purpura in children
Abstract
Objective: The objective of this study was to identify risk factors for developing chronic idiopathic thrombocytopenic purpura in a cohort of pediatric patients with idiopathic thrombocytopenic purpura.
Methods: We conducted a retrospective cohort analysis of 259 children who were diagnosed with idiopathic thrombocytopenic purpura between 1991 and 2000 at 1 of 8 managed care organizations that comprise the Vaccine Safety Datalink. We reviewed the charts of 595 potential patients with idiopathic thrombocytopenic purpura from the 8 Vaccine Safety Datalink sites and excluded patients with known causes of thrombocytopenia. Chronic idiopathic thrombocytopenic purpura was defined as having thrombocytopenia for 6 months beyond the initial diagnosis. The risk for developing chronic idiopathic thrombocytopenic purpura was assessed using simple and multivariable analyses.
Results: Of the 259 cases of idiopathic thrombocytopenic purpura, 197 (76%) were acute, 60 (23%) were chronic, and 2 (1%) could not be determined. Among the acute cases, the mean duration of illness was 22 days. There was 1 serious bleeding outcome in the cohort. In multivariable regression analysis, the patients with chronic illness were older, less likely to present with mucosal bleeding, less likely to have had an acute illness before diagnosis, and more likely to present with a platelet count > 20,000/microL than children with acute idiopathic thrombocytopenic purpura. In particular, children whose illness was diagnosed at > or = 10 years of age and who had platelet counts > or = 20,000/microL had an approximate fivefold risk for progressing to chronic disease when compared with children who presented at < or = 2 years of age with platelet counts < 20,000/microL.
Conclusions: Although idiopathic thrombocytopenic purpura tends to be a benign and self-limited condition, acute and chronic idiopathic thrombocytopenic purpura seem to be distinct illnesses defined by age, platelet count, bleeding symptoms, and the presence of acute illness before diagnosis. Physicians should be aware of these differences when advising their patients and families.
Similar articles
-
Risk of immune thrombocytopenic purpura after measles-mumps-rubella immunization in children.Pediatrics. 2008 Mar;121(3):e687-92. doi: 10.1542/peds.2007-1578. Pediatrics. 2008. PMID: 18310189
-
Predictive factors for successful laparoscopic splenectomy in patients with immune thrombocytopenic purpura.Arch Surg. 2004 Jan;139(1):61-6; discussion 66. doi: 10.1001/archsurg.139.1.61. Arch Surg. 2004. PMID: 14718278
-
Splenectomy for idiopathic thrombocytopenic purpura: a five-year retrospective review.Am Surg. 2000 Oct;66(10):952-4; discussion 955. Am Surg. 2000. PMID: 11261623
-
[Idiopathic thrombocytopenic purpura in children].Med Pregl. 1998 Mar-Apr;51(3-4):127-34. Med Pregl. 1998. PMID: 9611955 Review. Croatian.
-
Idiopathic autoimmune thrombocytopenic purpura.Adv Pediatr. 1994;41:111-34. Adv Pediatr. 1994. PMID: 7992681 Review.
Cited by
-
Recommendations for the management of acute immune thrombocytopenia in children. A Consensus Conference from the Italian Association of Pediatric Hematology and Oncology.Blood Transfus. 2024 May;22(3):253-265. doi: 10.2450/BloodTransfus.501. Epub 2024 Jan 29. Blood Transfus. 2024. PMID: 37677093 Free PMC article.
-
Children with Chronic Immune Thrombocytopenia Exhibit High Expression of Human Endogenous Retroviruses TRIM28 and SETDB1.Genes (Basel). 2023 Aug 1;14(8):1569. doi: 10.3390/genes14081569. Genes (Basel). 2023. PMID: 37628621 Free PMC article.
-
Predictor Factors for Chronicity in Immune Thrombocytopenic Purpura in Children.Children (Basel). 2023 May 23;10(6):911. doi: 10.3390/children10060911. Children (Basel). 2023. PMID: 37371143 Free PMC article.
-
Predictors of Remission in Severe Childhood Immune Thrombocytopenia.Diagnostics (Basel). 2023 Jan 17;13(3):341. doi: 10.3390/diagnostics13030341. Diagnostics (Basel). 2023. PMID: 36766447 Free PMC article.
-
U.S. Population-Based background incidence rates of medical conditions for use in safety assessment of COVID-19 vaccines.Vaccine. 2021 Jun 23;39(28):3666-3677. doi: 10.1016/j.vaccine.2021.05.016. Epub 2021 May 14. Vaccine. 2021. PMID: 34088506 Free PMC article. Review.
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Medical