CLINICAL AND LABORATORY CHARACTERISTICS OF IMMUNE THROMBOCYTOPENIC PURPURA IN CHILDREN

Objective. Description of clinical and laboratory characteristics of immune thrombocytopenic purpura in children, treatment choice and therapeutic response. Methods. Retrospective study with data from medical records of 87 patients of both sexes, aged up to 16 years, hospitalized at the Pediatric Clinic, Clinical Center, Kragujevac, from 01/10/2006 to 01/10/2012. All patients underwent a clinical examination (history, physical examination) and a laboratory examination (complete blood count, blood haemostatic tests – prothrombin time, International normalized ratio – INR, activated partial thromboplastin time – aPTT) combined with additional diagnostics (myelogram, abdominal ultrasound examination, serum immunoglobulins). Results. ITP appears with similar frequency in male and female children. The greatest incidence is at school age (55.2%). The peak of incidence is in autumn (34.5%) and winter (36.8%). The acute form of the disease appears in 90.8%, and the chronic form appears in 9.2% of patients. The majority of affected children (52.9%) had been suffering from respiratory infection in the previous three weeks. Predominant signs were petechiae (70.1%) and skin hematoma (59.8%). The greatest number of responders (66.7%) had platelet count below 20x10 9/l. Out of the total number of patients, 77.1% were treated only with corticosteroids. The treatment results were satisfactory. The signs of chronic ITP were developed by 8 (9.2%) patients who had not responded to therapy. Conclusion. ITP in children is usually an acute condition, equally represented by gender, in school age, in autumn and winter months, preceded by respiratory infection, manifested with the signs of hemorrhagic syndrome, particularly with petechiae and hematoma and it responds well to corticosteroids.