Variables related to chronic immune thrombocytopenia: experience from a single center and comparison to a meta-analysis

Eur J Pediatr. 2021 Jul;180(7):2075-2081. doi: 10.1007/s00431-021-03990-8. Epub 2021 Feb 16.

Abstract

Classically, several variables have been related to the disease course of chronic primary immune thrombocytopenia (cITP), though to date, there is no consensus on their clinical relevance. In a recent systematic review, a meta-analysis was made and confirmed the existence of certain cITP-related variables that may be related to prognosis in pediatric patients. We retrospectively analyzed a cohort of patients diagnosed with ITP, identified prognostic variables, and compared our results to the variables described by the authors. A multivariate study revealed that older age at diagnosis and higher platelet count were the only independent variables related to cITP. Children up to age 4 years and those with lower platelet counts (below 20 × 109/L) were at lower risk for cITP.Conclusion: We therefore concluded that only age and platelet count at diagnosis are independent variables that should be considered when evaluating the risk of developing cITP. What is Known: • Around 20% of patients with immune thrombocytopenia progress to chronic disease as determined by a sustained platelet count below 100×109/L for more than 12 months. • A number of variables potentially related to the development of cITP are being studied, such as age, sex, cell count, and previous treatment. What is New: • This is a new group of patients diagnosed with ITP in which the platelet count and age at diagnosis are the only independent variables closely related to cITP. • In this new series, we could not confirm other variables previously related to cITP such as total leukocyte count or the absence of treatment at diagnosis.

Keywords: Chronic primary immune thrombocytopenia; ITP; Platelet count; cITP; predictors.

Publication types

  • Meta-Analysis

MeSH terms

  • Aged
  • Child
  • Child, Preschool
  • Chronic Disease
  • Humans
  • Platelet Count
  • Purpura, Thrombocytopenic, Idiopathic* / diagnosis
  • Purpura, Thrombocytopenic, Idiopathic* / epidemiology
  • Retrospective Studies
  • Thrombocytopenia*