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Duration and morbidity of chronic immune thrombocytopenic purpura in children: five‐year follow‐up of a Nordic cohort

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Aim:  To describe the clinical course, morbidity and platelet recovery in an unselected Nordic cohort of children with chronic Immune Thrombocytopenic Purpura (ITP).

Methods:  Prospective 5‐year follow‐up of 96 children with ITP lasting more than 6 months, with reporting of hospital admissions, severity of bleeding episodes and stabilization of platelet counts above 20, 50 and 150 × 109/L.

Results:  The estimated 5‐year recovery rate was 52%; exclusion of 12 splenectomized children did not change the estimate. Events eliciting admission to hospital occurred in 39 (41%). Major haemorrhages occurred in eight children (8%), including a nonfatal intracranial haemorrhage in one child (1%). The overall admission rate was 0.4/year of thrombocytopenia, decreasing during follow‐up as thrombocytopenia converted to milder degrees. Early recovery within 2 years of diagnosis occurred in 35%, was associated with low morbidity and was more likely in young children with abrupt onset of symptoms.

Conclusion:  In a Nordic cohort of children with chronic ITP, one half had recovered 5 years after diagnosis, more than half never required hospitalization and <10% experienced serious bleeding episodes, always with a platelet count <20 × 109/L. Aggressive management can be restricted to the minority of children with continuing severe thrombocytopenia and frequent, clinically significant bleeding events.

Document Type: Research Article


Affiliations: 1: .Pediatric Department, Aarhus University Hospital, Aalborg Hospital, Aalborg, Denmark 2: .Children’s Hospital, Helsinki University Central Hospital and University of Helsinki, Finland 3: .Sachs Childrens Hospital, Stockholm South General Hospital, Stockholm, Sweden 4: .Pediatric Department, Oslo University Hospital, Rikshospitalet, Oslo, Norway 5: .Pediatric Department, Malmø University Hospital, Malmø, Sweden 6: .Childhood Cancer Research Unit, Department of Women’s and Children’s Health, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

Publication date: 2012-07-01

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