Clinical features and treatment outcomes of 79 infants with immune thrombocytopenic purpura.

ABSTRACT

BACKGROUND: To determine the clinical features and treatment outcomes of infants with immune thrombocytopenic purpura (ITP). METHODS: Retrospective analysis of 79 infant ITP patients treated from 1987 to 2002. The data abstracted comprised age, gender, clinical features, and treatment outcomes. A score test for the trend in the odds ratios was used to determine the risk of chronic ITP with advancing age. The infants were compared to a group of contemporaneous older children with regard to bleeding severity and incidence of chronic ITP. RESULTS: The 34 female and 45 male infants had a median age of 16 months. Seventy-four presented with purpura, four with viral illnesses, and one was asymptomatic. Eight percent had active mucosal bleeding. The median platelet count was 8,000/microl. Forty infants received intravenous immunoglobulin, nine intravenous anti-D immunoglobulin, six steroids, and seven were observed without treatment. Fifty-five (76%) responded to a single course of treatment. Only 9% of infants developed chronic ITP compared to 18% of children between the ages of 25 and 119 months and 47% of children 120 months or older (P<0.0005). CONCLUSIONS: Infants with ITP respond favorably to treatment and are less likely to develop chronic ITP compared to older children.