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Acute Idiopathic Thrombocytopenic Purpura (acute + idiopathic_thrombocytopenic_purpura)
Selected AbstractsInterferon-alpha therapy in idiopathic thrombocytopenic purpuraPEDIATRICS INTERNATIONAL, Issue 6 2001Bunyamin Dikici AbstractBackground: Acute idiopathic thrombocytopenic purpura (ITP) represents the most frequent hemorrhagic diathesis in childhood. Up to 30% of patients with ITP are regarded as refractory to standard therapy. The rare mortality from acute ITP in childhood is almost exclusively due to intracranial hemorrhage. This complication occurs in less than 1% of ITP patients. This study was designed to evaluate the effect of ,-interferon (IFN-,) in eight patients whom did not respond to conventional therapy. Method: In spite of conventional therapies, the patient whose platelet count could not be increased to 50`109/L were accepted as refractory ITP. Eight of these patients whose platelet count lower than 20`109/L were included in the prospective cohort study. Interferon alpha 2b 5 MU/m2 was administered subcutaneously three times a week, totalling 12 times in a month. According to the platelet count on the 28th day of therapy, we grouped the patients into three categories. After 60 days, the survey was re-evaluated according to the platelet count. Results: The mean age of children was 3.5±2.5 (ranged between 3.5 and 9) years. Six of them were boys and two were girls. There was no response in one patient, partial response in one, and good response in six patients on the 28th day of therapy. The maximum rise in platelet count was observed from 7 to 14 days after the initiation of interferon. The median platelet count which was 15±5`109/L before therapy, raised to 60±12`109/L after therapy. However, on the 60th day of therapy, there were only two patients who had a platelet count over 100`109/L. Conclusion: In our study, we did not observe the long-term benefit of IFN-, therapy in refractor ITP in childhood. However, in good responding patients, platelet levels were increased in a short time. Alpha-interferon may be alternative therapy for patients whom had a platelet count below 20`109/L and not responding to standard therapy, or for patients whom immunosuppressive therapy is contraindicated. [source] Intended management of children with acute idiopathic thrombocytopenic purpura: A national surveyJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 1-2 2005MK Marks Objective: In Australia acute idiopathic thrombocytopenic purpura (ITP) is mainly treated by paediatricians (either general paediatricians or paediatric haematologists/oncologists). A survey was conducted to gauge the current practice of treating children with acute ITP in Australia. Methods: All practising Australian paediatricians registered by the Royal Australasian College of Physicians were surveyed regarding their intended management of children with acute ITP. The questionnaire, adapted from a study of paediatric haematologists/oncologists in North America, presented four clinical scenarios of children with acute ITP with a platelet count of 3000 × 109/L, with and without mucosal bleeding (wet and dry purpura, respectively). Questionnaires were returned by mail or filled in online at a dedicated webpage. Results: Five hundred and sixty-three of 1097 (51%) paediatricians responded to the survey. Data from 140 who had treated at least one child with ITP in the previous 12 months were analysed. Respondents indicated that children with acute ITP are usually or always hospitalised (58,92%) and that 48% would be given active treatment, even with dry purpura. Various regimens of i.v. immunoglobulin or corticosteroids are used when treatment is administered. In comparing Australian and North American management of acute ITP there were many similarities, although Australian paediatricians were less likely to arrange a bone marrow aspirate if corticosteroids were prescribed. Conclusions: There is great variation in the intended management of children with acute ITP in Australia. Previously published management recommendations regarding investigation and treatment have had little impact on intended practice. Prospective studies are required to evaluate hypotheses so as to produce evidence-based recommendations for treatment of patients with acute ITP. [source] Anaesthesia for urgent splenectomy in acute idiopathic thrombocytopenic purpuraANAESTHESIA, Issue 2 2009A. J. Trimmings No abstract is available for this article. [source] | ||||||||||