Retrospective Evaluation of Chronic Idiopathic Thrombocytopenia in Libyan Children

Abstract

Immune thrombocytopenic purpura (ITP) is the most common cause of acquired thrombocytopenia in children. Approximately 10-20% of children with Immune thrombocytopenia (ITP) suffer from a chronic clinical disease that requires follow up and medical intervention according to the severity of bleeding manifestation. Aims: To evaluate the demographic, clinical, and laboratory features, treatment modalities, and response to therapy in Libyan children with chronic idiopathic thrombocytopenia. Methods: A retrospective study was conducted at the hematology clinic of the pediatric department, Benghazi medical center, and Benghazi Children Hospital. The duration of the study was from January 1998 to December 2018. comprised of demographics, clinical, laboratory data, therapy and therapy response in Libyan chronic ITP. Results: In our study, the mean age of chronic ITP patients was 4.9 years, slightly higher in male patients 43 (52.4%) With a male/female ratio 1.1:1. The most frequent symptoms were mild   which were limited to bruises and petechiae on the skin. (57.3%). The preceding history of viral infection was uncommon in patients with chronic ITP (22%) while the past history of MMR vaccination is quite rare and constituted only (2%). The mean platelet count before treatment (i.e. at presentation) was (22.7x109/L) while mean platelet count after treatment (213.6 x109/L. Treatment consisted of combined Steroid + IVIG in 27 (77.1% response), steroids in 23 (73.9% response), intravenous immunoglobulin (IVIG) in 11 (90.9% response), and no therapy in 21 (95.2% response).Complete response was achieved in 82.9% % showed a complete response either spontaneous or following the treatment. No patient was presented with intracranial hemorrhage. Conclusions: Chronic ITP in Libyan children had a benign nature, none of our patients developed severe symptoms as life-threatening bleeding like CNS bleeding or died, IVIG give more optimistic response as compare to steroid. And the majority of children with chronic ITP in this study achieved remission.