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
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.
