Arch Dis Child. Published Online First: 25 April 2007. doi:10.1136/adc.2006.098442
Original articles |
Does treatment of newly diagnosed idiopathic thrombocytopenic purpura reduce morbidity?
1 Sach's Children's Hospital, Sweden
2 Jorvi Hospital, Finland
3 Rikshospitalet, Oslo, Norway
4 Karolinska University Hospital, Sweden
5 Aalborg Hospital, Denmark
* To whom correspondence should be addressed. E-mail: steen.rosthoej{at}rn.dk.
Accepted 13 April 2007
Abstract
Purpose: To explore whether early treatment of children with idiopathic thrombocytopenic purpura (ITP) with immunoglobulin and/or corticosteroids reduces subsequent morbidity.
Design: Centers participating in a Nordic ITP study were divided according to whether they had treated more than 2/3, from 1/3 to 2/3, or less than 1/3 children within 14 days of diagnosis. The course of disease from 15 days to six months after diagnosis was compared for children managed at the three center categories. The comparison was restricted to children in whom at least one platelet count < 20 x 109/l was measured, numbering 156, 143 and 84.
Results:The three groups of children were clinically similar but were managed with initial treatment rates of 89%, 57% and 14%, respectively. By day 15, the platelet count had stabilised > 20 x 109/l in 67%, 67% and 52% (p < 0.05) and > 150 x 109/l in 38%, 29% and 29% (p < 0.20). One month after diagnosis there was no difference in recovery rates. Chronic ITP developed in 27%, 22% and 25% in the three groups. During follow-up, one or more disease-related events occurred in 23%, 22% and 19%, without any difference in the average numbers of episodes with mucosal bleeding. Treatment courses were administered to 19%, 13% and 11%, respectively.
Conclusion: Active treatment policies accelerated platelet recovery in children with short-lasting ITP but did not avert the development of chronic ITP and did not cause a reduction in morbidity during follow-up.
Keywords: corticosteroid therapy, idiopathic thrombocytopenic purpura, immunoglobulin therapy
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
Relevant Article
-
A brief digest of the August issue
Arch. Dis. Child. 2007 92: e8.[Extract] [Full Text] [PDF]
eLetters:
Read all eLetters
- Evidence calls for paradigm shift towards non aggressive approach in immune thrombocytopenic purpura
- P Anoop
- ADC Online, 24 Jul 2007 [Full text]
- Evidence calls for paradigm shift towards non aggressive approach in immune thrombocytopenic purpura
- P Anoop
- ADC Online, 27 Jul 2007 [Full text]
- Full Text (Rapid PDF)
-
All Versions of this Article:
adc.2006.098442v1
92/8/704 most recent - Submit a response
- Read responses to this article
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
Services
- Email this link to a friend
- Similar articles in ADC Online
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
