Background and aims The primary immune thrombocytopenia (ITP) in children has a favourable evolution in most of cases. Chronic ITP has been noted in 14–30% of the cases. This study reviewed the pattern of presentation and response to therapy in patients with ITP, in order to identify risk factors for chronic disease.
Methods We conducted a retrospective study of all cases of ITP in paediatrics and haematological departments of Hedi Chaker University Hospital in Sfax, during a period of 15 years (1995 to 2009). Predictors of chronicity were investigated using Fisher’s test with a significance if p < 0.05.
Results 140 cases of ITP were collected including 75 girls (54%) and 65 boys (46%). The average age was 6 years 7 months (3 months to 15 years). The diffuse mucocutaneous purpura was constant and mucosal haemorrhages were present in one third of cases. The mean platelet count was 25000/mm3 (1000/mm3 to 50000/mm3). Therapeutic abstention was the rule in 19 cases (14%), 111 children received corticosteroids (79%) and 10 children received immunoglobulins associated with corticosteroids (7%). Fifteen patients were lost of follow up and evolution has identified two groups: acute ITP in 95 cases (67%), and chronic ITP in 30 cases (21%). The parameters that were found as predictors of chronicity were female sex and age.
Conclusions Acute ITP is the most common. Chronic forms are found in one fifth of cases. The determination of risk factors for chronicity can make an early prognosis.