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Changing trends in the UK management of childhood ITP


Objective To compare the treatment of childhood immune thrombocytopenia (ITP) with historical practice in the UK.

Design Data collection through a national UK Childhood ITP registry ( started in January 2007.

Settings UK hospitals.

Participants Children admitted with a new diagnosis of acute ITP and their treating physicians.

Main outcome measures Bleeding severity, platelet count, disease management and outcome from the time of presentation to 6 months.

Results Data from 225 children were analysed. 54% of children had clinically mild, 42% had moderate and 4% had severe disease as defined previously.1 The mean platelet counts at diagnosis for these groups were 14, 8 and 6×109/l respectively. Children with mild disease had fewer bleeding sites (1.9), compared with moderate (2.5) or severe disease (3.6). There was one intracranial haemorrhage reported. At 6 months' follow-up, 32% had a persistent platelet count <150×109/l, but only 4.8% had a count <20. The proportion of UK children receiving platelet-raising treatment was noted to decrease from 61% in 1995 to 38% in 2000. The current UK 2009 registry data show a continued decrease in treatment to 16% of all the children. In contrast, historical international data report 69% of children receiving interventional therapy.

Conclusion The current UK practice has shown a continued reduction in the number of children receiving treatment in comparison with historical data and international practice.

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