[Childhood idiopathic thrombocytopenic purpura (the results of 20-year experience)].

ABSTRACT

Idiopathic thrombocytopenic purpura (ITP) of Childhood is a common hemorrhagic diathesis. The purpose of the present work is to summarize the results of 20-year observation over children suffering ITP, to record certain progress in diagnosing and treatment of this disease and to raise the problems still to be solved. The authors have been observing 181 ITP patients (girls 89, boys 92) at the age of 3 months up to 15 years. Childhood ITP mostly occurs at the age of 1 to 6 year i.e. in the so called "critical period" of immune system forming. Several peculiar cases were identified among infants and the children above 10 years old. Clinical manifestation of all the ITP patients was characterized with cutaneous hemorrhagic syndrome. 95% of childhood cases showed deep thrombocytopenia with the thrombocyte level <30X10 9/l. Most of the patients suffered acute form of ITP (87,9%). In the majority of cases illness took its normal predictable course after the glucocorticosteroid therapy. In heavy cases the combination of glucocorticosteroid and intravenous immunoglobulin is recommended. The indications of splenectomy were considered to be heavy, life -threatening, excessive bleeding, mainly in cases of chronic, steadily recurrent forms of ITP. Remissions were achieved in most of cases.