A Nationwide Survey of Childhood Idiopathic Thrombocytopenic Purpura in 2006

Abstract

In order to clarify the clinical pictures, outcome for childhood idiopathic thrombocytopenic purpura (ITP) and the trends of the choice of management, questionnaires were sent to all the councilors of the Japanese Society of Pediatric Hematology every year since 2000. In 2007 we conducted the same survey on ITP patients newly diagnosed between January 2006 and December 2006 and on the follow-up cases. Of 167 patients, 94 were boys and 73 were girls. The male-to-female ratio was 1.29 : 1. The mean age at diagnosis was 3.93 ± 3.63. The occurrence of ITP peaked in children under or less than 1 year of age, and the number of cases gradually decreased with age. The platelet counts at diagnosis were under 10, 000/ μl in more than half of the patients. In the initial treatment, morethan 80% of the patients with platelet counts < 10, 000/ μl were treated with IVIgG, whereas in the patients with platelet counts > =20, 000/ μl more than half of the patients were observed without any treatment. 26.4% of the cases were diagnosed as chronic ITP. The frequency of chronic ITP was increased according to the increase of age and wasextremely low in the patients with antecedent vaccination. In 199 follow-up cases, 48 cases received no medication and 28 cases underwent a splenectomy.