New Article - ITP, Children and Remission

Long-term follow-up of children with immune thrombocytopenia (ITP) indicates that the majority undergo remission and severe thrombocytopenia is infrequent. Details regarding bleeding manifestations, however, remain poorly categorized. We report here long-term follow-up data of patients enrolled in ICIS Registry II focusing on natural history, bleeding manifestations, and clinical management. Data on 1,345 subjects was collected at diagnosis, 28 days and 6, 12, and 24 months thereafter. Median platelet counts were 214 x 109/l (IQR 227, range 1-748), 211 x 109/l (IQR 192, range 1-594), and 215 x 109/l (IQR 198, range 1-598) at 6, 12, and 24 months respectively and a platelet count < 20 x 109/l, was uncommon (7%, 7%, and 4% respectively). Remission was observed in 37% of patients between 28 days and 6 months, 16% between 6 and 12 months, and 24% between 12 and 24 months. There were no reports of intracranial hemorrhage, and the most common site of bleeding was skin. In patients with severe thrombocytopenia we observed a trend towards more drug treatment with increasing number of bleeding sites. Our data support that ITP is a benign condition for most affected children and that major hemorrhage, even with prolonged severe thrombocytopenia, is rare.


bloodjournal.hematologylibrary.org/content/early/2013/04/02/blood-2012-12-466375.abstract?ct&ct=7d1063fc8d011d995bec3f9902f4525aa4d47c1970fb06362303cd9faef38f2a14763e431bd2e9f0a6c0c2625b4f4fe4bf72f611030cb15b38b3b243ab156de4

Those figures are way, way different than I've heard before - always heard that about 80% of kids got better within the first six months. This seems more realistic given the stories I've read over the last four years. Patience and calmness are the keys here I think.

P.s. Always knew Dougie was "special", but I wish he wasn't in this 4%!!!!

I know, Alison. I wish he weren't either! But since he is, he is lucky to have one very level headed, educated Mom!

What ages are considered children? My son is 15 and I have confused about the numbers since he seems to fall in the middle.

Dougie was diagnosed at the age of 10 and a 1/2 and I seem to remember the doctor saying that 11 was some kind of a cut off where it tended to be like adult ITP after that. But I don't think thats a fixed boundary, and there have been lots of teenagers who seemed to have acute ITP on this board over the years. And clearly, there are younger children who have chronic ITP. Even having chronic ITP doesn't mean that its never going to go away though.