G540(P) Children with chronic itp, do they bleed?. (May 2019)

• Record Type: Journal Article
• Authors: Muninarayan, D; Durgappa, T; Simon, A; Bharadwaj, V; Prakash, A
• Is Part Of: Archives of disease in childhood. Volume 104:(2019)Supplement 2
• Page Start: A218
• Page End: A218
• Publication Date: 2019-05
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2019-rcpch.523
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Objective: To study the clinical profile and bleeding manifestations in children with chronic ITP. Design: Retrospective observational study. Study Setting: Paediatric Haematology and Oncology Division Of a tertiary hospital in Bangalore, India. Participants: All children diagnosed with chronic immune thrombocytopenia presenting to Pediatric Hematology and Oncology division of St John's Medical College Hospital between January 2012 and June 2017. Results: We analysed one hundred and ten children with chronic ITP. The mean age of children with cITP was 8.01 years (SD 4.25) and male to female ratio was 0.86:1.Ninety five percent had skin bleeds, fourty six percent had epistaxis, fifteen percent had gumbleed, GI bleeding including haematemesis and malaena for nineteen percent, menorrhagia for twelve percent, haematuria for eight percent, intracranial bleed for six percent. Thirty two children (29.09%) had severe bleeding, thirty seven (33.6%) had moderate bleeding, forty one (37.2%) had mild bleeding symptoms. Sixty eight children (61.8%) had very severe thrombocytopenia (<20000), thirty seven (33.64%) had severe thrombocytopenia (<50, 000) and four (3.6%) had moderate thrombocytopenia (50, 000–1, 00, 000). No significant association between platelet count with severity of bleed (p-0.15). However those with severe bleeding manifestations 78.1% had severe thrombocytopenia. Conclusion: Skin bleed remains the most common bleeding phenotype in children with cITP.Children with multiple sites of bleeding and moderate bleeding are at risk of severe life threatening bleeds. This study highlights the need for close follow up and treatment of these high risk children. References: AH Shaban, AF Mazin, GH Hasanein, et al . Chronic immune thrombocytopenic purpura in children overview of 60 patients. PediatricHematology Oncology Journal 1 (2016) 9e12. Kuhne T, Imbach P, Bolton-Maggs PH, Berchtold W, Blanchette V, Buchanan GR; Intercontinental childhood ITP Study Group. Newly diagnosed idiopathic thrombocytopenic purpura in childhood:an observational study. Lancet 2001 Dec2–29;358(9299):2112–2125. Cindy E Neunert.Currentmanagementof immune thrombocytopenia. The American society of haematology 2011 evidence based practice guideline for immune thrombocytopenia. Blood2011;117(16):4190–4207.