Aim: To describe the epidemiology of idiopathic thrombocytopenic purpura (ITP ) in the Nordic countries, to define clinical subgroups and to investigate facto rs predicting chronic disease. Methods: A prospective regi...Aim: To describe the epidemiology of idiopathic thrombocytopenic purpura (ITP ) in the Nordic countries, to define clinical subgroups and to investigate facto rs predicting chronic disease. Methods: A prospective registration was done from 1998 to 2000, including all children with newly diagnosed ITP aged 0- 14 y and at least one platelet count < 30 × 109/l. Results: 506 children were register ed and 423 followed for 6 mo. The incidence was 4.8/105 per year. Most children were aged 0- 7 y (78% ), with a predominance of boys, while patients aged 8- 14 y had equal representation of the two sexes. There were seasonal variations d etermined by variations in postinfectious cases with sudden onset. The platelet count was < 10 × 109/l in 58% , but bleeding manifestations were mild or mode rate in 97% . The insidious form (symptoms for more than 2 wk) was more frequen t in older children and girls, showed little seasonal variation, had milder mani festations and ran a chronic course in more than half the cases. Intracranial haemorrhages did not occur in the first 6 mo after diagnosis. Chronic ITP developed in 25% . The st rongest predictor of chronic disease was insidious onset of symptoms (OR 5.97). Conclusion: In the Nordic countries, ITP mainly affects children aged 0- 7 y, w ith a winter bulk of postinfectious cases superimposed on a steady occurrence of non- infectious cases. Clinically, it may be useful to distinguish between chi ldren with sudden versus insidious onset of symptoms rather than between differe nt age groups.展开更多
Aim: To describe the management practices of newly diagnosed childhood idiopathic thrombocytopenic purpura (ITP) in the Nordic countries. Methods: A prospective registration was done from 1998 to 2000, including all c...Aim: To describe the management practices of newly diagnosed childhood idiopathic thrombocytopenic purpura (ITP) in the Nordic countries. Methods: A prospective registration was done from 1998 to 2000, including all children with newly diagnosed ITP aged 0-14 years. Results: 506 children from 98 departments were registered.A diagnostic bone marrow aspiration was obtained within 14 days in 33%. Platelet and/or red blood cell transfusion was given in 11%. 287 children (57%) received platelet-enhancing therapy with intravenous immune globulin (IVIG) or corticosteroids within 14 days of diagnosis, IVIG being the first line choice in over 90%of the cases. There were noticeable national differences in the management. The decision to start drug treatment within two days of diagnosis was influenced mainly by the platelet count. Neither early treatment nor response to treatment changed the risk of chronic disease. Conclusion: This study has shown a great variation in the management practices of children with newly diagnosed ITP. Prospective studies are required to produce evidence-based recommendations for this patient group.展开更多
文摘Aim: To describe the epidemiology of idiopathic thrombocytopenic purpura (ITP ) in the Nordic countries, to define clinical subgroups and to investigate facto rs predicting chronic disease. Methods: A prospective registration was done from 1998 to 2000, including all children with newly diagnosed ITP aged 0- 14 y and at least one platelet count < 30 × 109/l. Results: 506 children were register ed and 423 followed for 6 mo. The incidence was 4.8/105 per year. Most children were aged 0- 7 y (78% ), with a predominance of boys, while patients aged 8- 14 y had equal representation of the two sexes. There were seasonal variations d etermined by variations in postinfectious cases with sudden onset. The platelet count was < 10 × 109/l in 58% , but bleeding manifestations were mild or mode rate in 97% . The insidious form (symptoms for more than 2 wk) was more frequen t in older children and girls, showed little seasonal variation, had milder mani festations and ran a chronic course in more than half the cases. Intracranial haemorrhages did not occur in the first 6 mo after diagnosis. Chronic ITP developed in 25% . The st rongest predictor of chronic disease was insidious onset of symptoms (OR 5.97). Conclusion: In the Nordic countries, ITP mainly affects children aged 0- 7 y, w ith a winter bulk of postinfectious cases superimposed on a steady occurrence of non- infectious cases. Clinically, it may be useful to distinguish between chi ldren with sudden versus insidious onset of symptoms rather than between differe nt age groups.
文摘Aim: To describe the management practices of newly diagnosed childhood idiopathic thrombocytopenic purpura (ITP) in the Nordic countries. Methods: A prospective registration was done from 1998 to 2000, including all children with newly diagnosed ITP aged 0-14 years. Results: 506 children from 98 departments were registered.A diagnostic bone marrow aspiration was obtained within 14 days in 33%. Platelet and/or red blood cell transfusion was given in 11%. 287 children (57%) received platelet-enhancing therapy with intravenous immune globulin (IVIG) or corticosteroids within 14 days of diagnosis, IVIG being the first line choice in over 90%of the cases. There were noticeable national differences in the management. The decision to start drug treatment within two days of diagnosis was influenced mainly by the platelet count. Neither early treatment nor response to treatment changed the risk of chronic disease. Conclusion: This study has shown a great variation in the management practices of children with newly diagnosed ITP. Prospective studies are required to produce evidence-based recommendations for this patient group.
