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Characterization of chronic idiopathic thrombocytopenic purpura in Japanese children: a retrospective multi-center study

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Abstract

The objectives of this study are to clarify (1) the difference in demographic and clinical variables at initial presentation between acute and chronic idiopathic thrombocytopenic purpura (ITP), and (2) the prognostic factors of patients with chronic ITP. We conducted a retrospective analysis of 247 children with newly diagnosed ITP between April 1991 and March 2006 who visited one of the 12 hospitals belonging to the Kyoto University Pediatric Hematologic Study Group. 180 and 67 cases were classified as the acute type and as the chronic type, respectively. Older age, higher initial platelet count, positive medical history or concomitant medical diagnosis, the absence of preceding infection or vaccination, and the absence of an increase in immunoglobulin were risk factors for the chronicity. The prognostic factors in chronic ITP were evaluated in 53 patients after excluding patients receiving splenectomy or having insufficient follow-up data. The overall time required for 50% resolution in patients with chronic ITP was approximately 5.6 years. Age at presentation of less than 3 years and higher platelet counts at the time of chronic ITP diagnosis were good prognostic factors. On the other hand, gender, initial platelet counts, and preceding infection or vaccination were not associated with the prognosis.

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References

  1. Lilleyman JS. Management of childhood idiopathic thrombocytopenic purpura. Br J Haematol. 1999;105:871–5.

    Article  CAS  PubMed  Google Scholar 

  2. Bolton-Maggs PHB. Idiopathic thrombocytopenic purpura. Arch Dis Child. 2000;83:220–2.

    Article  CAS  PubMed  Google Scholar 

  3. Geddis AE, Balduini CL. Diagnosis of immune thrombocytopenic purpura in children. Curr Opin Hematol. 2007;14:520–5.

    Article  PubMed  Google Scholar 

  4. Fogarty PF, Segal JB. The epidemiology of immune thrombocytopenic purpura. Curr Opin Hematol. 2007;14:515–9.

    Article  PubMed  Google Scholar 

  5. Sutor AH, Harms A, Kaufmehl K. Acute immune thrombocytopenia (ITP) in childhood: retrospective and prospective survey in Germany. Semin Thromb Hemost. 2001;27:253–67.

    Article  CAS  PubMed  Google Scholar 

  6. Zeller B, Rajantie J, Hedlund-Treutiger I, et al. Childhood idiopathic thrombocytopenic purpura in the Nordic countries: epidemiology and predictors of chronic disease. Acta Paediatr. 2005;94:178–84.

    Article  PubMed  Google Scholar 

  7. Low EJ, Buchanan GR. Idiopathic thrombocytopenic purpura diagnosed during the second decade of life. J Pediatr. 2002;141:253–8.

    Article  Google Scholar 

  8. Belletrutti M, Ali K, Barnard D, et al. Chronic immune thrombocytopenic purpura in children: a survey of the Canadian experience. J Pediatr Hematol Oncol. 2007;29:95–100.

    Article  PubMed  Google Scholar 

  9. Marks MK, Vadamalayan B, Ekert H, et al. Intended management of children with acute idiopathic thrombocytopenic purpura: a national survey. J Paediatr Child Health. 2005;41:52–5.

    Article  CAS  PubMed  Google Scholar 

  10. Zhao H, Li H, Zhang L, et al. Retrospective analysis of 472 Chinese children with chronic idiopathic thrombocytopenic purpura: a single center experience. Haematologica. 2005;90:860–1.

    PubMed  Google Scholar 

  11. Shirahata A, Fujisawa K, Ishii E, et al. A nationwide survey of newly diagnosed childhood idiopathic thrombocytopenic purpura in Japan. J Pediatr Hematol Oncol. 2009;31:27–32.

    Article  PubMed  Google Scholar 

  12. Kawai C. In Laboratory reference ranges for normal Japanese children [in Japanese]. Tokyo: Japan Public Hygiene Society; 1996. p. 264–76.

    Google Scholar 

  13. Shirahata A, Ishii E, Eguchi H, et al. Consensus guideline for diagnosis and treatment of childhood idiopathic thrombocytopenic purpura. Int J Hematol. 2006;83:29–38.

    Article  PubMed  Google Scholar 

  14. Robb LG, Tiedeman K. Idiopathic thrombocytopenic purpura: predictors of chronic disease. Arch Dis Child. 1990;65:502–6.

    Article  CAS  PubMed  Google Scholar 

  15. Kühne T, Buchanan GR, Zimmerman S, et al. A prospective comparative study of 2540 infants and children with newly diagnosed idiopathic thrombocytopenic purpura (ITP) from the Intercontinental Childhood ITP Study Group. J Pediatr. 2003;143:605–8.

    Article  PubMed  Google Scholar 

  16. Granz J, France E, Xu S, et al. A population-based, multisite cohort study of the predictors of chronic idiopathic thrombocytopenic purpura in children. Pediatrics. 2008;121:e506–12.

    Article  Google Scholar 

  17. Edslev PW, Rosthøj S, Treutiger I, et al. A clinical score predicting a brief and uneventful course of newly diagnosed idiopathic thrombocytopenic purpura in children. Br J Haematol. 2007;138:513–6.

    Article  PubMed  Google Scholar 

  18. Acharya S, Bussel JB. Hematologic toxicity of sodium valproate. J Pediatr Hematol Oncol. 2000;22:62–5.

    Article  CAS  PubMed  Google Scholar 

  19. Trachil J, Hall GW. Is this immune thrombocytopenic purpura? Arch Dis Child. 2008;93:76–81.

    Article  Google Scholar 

  20. Kubota M, Usami I, Kobayashi K, et al. Serum immunoglobulin levels at onset: association with the prognosis of childhood idiopathic thrombocytopenic purpura. Int J Hematol. 2003;77:304–7.

    Article  CAS  PubMed  Google Scholar 

  21. Reid MM. Chronic idiopathic thrombocytopenic purpura: incidence, treatment, and outcome. Arch Dis Child. 1995;72:125–8.

    Article  CAS  PubMed  Google Scholar 

  22. Tamary H, Kaplinsky C, Levy I, et al. Chronic childhood idiopathic thrombocytopenia purpura: long-term follow-up. Acta Paediatr. 1994;83:931–4.

    Article  CAS  PubMed  Google Scholar 

  23. Donato H, Picón A, Rapetti MC, et al. Splenectomy and spontaneous remission in children with chronic idiopathic thrombocytopenic purpura. Pediatr Blood Cancer. 2006;47:737–9.

    Article  PubMed  Google Scholar 

  24. Imbach P, Kühne T, Müller D, et al. Childhood ITP: 12 months follow-up data from the prospective registry I of the Intercontinental Childhood ITP Study Group (ICIS). Pediatr Blood Cancer. 2006;46:351–6.

    Article  CAS  PubMed  Google Scholar 

  25. Rodeghiero F, Stasi R, Gemsheimer T, et al. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international group. Blood. 2009;113:2386–93.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Faculty of Human Life and Environment, Nara Women’s University, Kitauoya-nishi Machi, Nara, Japan

    Masaru Kubota

  2. Department of Pediatrics, Kyoto University Hospital, Kyoto, Japan

    Souichi Adachi

  3. Department of Pediatrics, Kobe City Medical Center General Hospital, Kobe, Japan

    Ikuya Usami

  4. Department of Pediatrics, Matsue Red Cross Hospital, Matsue, Japan

    Masayuki Okada

  5. Department of Pediatrics, Shiga Medical Center for Children, Moriyama, Japan

    Toshiyuki Kitoh

  6. Department of Pediatrics, Kitano Hospital, Osaka, Japan

    Mitsutaka Shiota

  7. Department of Pediatrics, Fukui Red Cross Hospital, Fukui, Japan

    Yoshihiro Taniguchi

  8. Department of Pediatrics, Fukui University Hospital, Fukui, Japan

    Akihiko Tanizawa

  9. Department of Pediatrics, Tenri Hospital, Tenri, Japan

    Mitsuhiko Nanbu

  10. Department of Pediatrics, Wakayama Red Cross Medical Center, Wakayama, Japan

    Keigo Hamahata

  11. Department of Pediatrics, Kishiwada City Hospital, Kishiwada, Japan

    Hisanori Fujino

  12. Department of Pediatrics, Nishi-Kobe Medical Center, Kobe, Japan

    Kousaku Matsubara

  13. Department of Pediatrics, Kyoto-Katsura Hospital, Kyoto, Japan

    Yoshihiro Wakazono

  14. Center for iPS Cell Research and Application, Kyoto University, Kyoto, Japan

    Tatsutoshi Nakahata

Authors
  1. Masaru Kubota
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  2. Souichi Adachi
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  3. Ikuya Usami
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  4. Masayuki Okada
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  5. Toshiyuki Kitoh
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  6. Mitsutaka Shiota
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  7. Yoshihiro Taniguchi
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  8. Akihiko Tanizawa
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  9. Mitsuhiko Nanbu
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  10. Keigo Hamahata
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  11. Hisanori Fujino
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  12. Kousaku Matsubara
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  13. Yoshihiro Wakazono
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  14. Tatsutoshi Nakahata
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Corresponding author

Correspondence to Masaru Kubota.

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Kubota, M., Adachi, S., Usami, I. et al. Characterization of chronic idiopathic thrombocytopenic purpura in Japanese children: a retrospective multi-center study. Int J Hematol 91, 252–257 (2010). https://doi.org/10.1007/s12185-009-0484-1

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  • DOI: https://doi.org/10.1007/s12185-009-0484-1

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