Comparison study of idiopathic thrombocytopenic purpura in the children below 3 years old with above 3 years old

LIU Qiao; XIAN Ying; DAI Bi-tao; XU You-hua; XIAO Jian-wen; WANG Shi-yi; LU Ling-ling; YU Jie

Abstract：Objective To study the clinical features of pediatric patients with idiopathic thrombocytopenic purpura (1TP) from infancy to adolescence, and compare their treatment response and the effects. Methods The data of the ITP children diagnosed and administrated between 2006～2008 were collected and analyzed by soft ware SPSS 12.0. The patients were divided into infant group (< 3 years old) and elder group (> 3 years old). The gender, demographic information, platelet count at the diagnosis, bleeding and anemia, virus infection and megakaryocytes, and most importantly, the treatment response were evaluated. Results (1 )The percentage of the male in infant group (66%) was statistically higher than that (50.6% ) in the elder group ( P = 0.031). (2) The incidence of epistaxis in the infant group (9.7% , n - 10) was statistically lower than that (43.7%) in the elder group (P < 0.001). The incidence of bleeding-caused anemia in the infant group (11.7%) was statistically lower than that (43.7%) in the elder children (P = 0.001). (3) The incidence of viral enteritis as a motivation in the infant group (14.56% ) was statistically higher than that (1.15%) in the elder group (P = 0.001); the incidence of vaccine inoculation as a motivation in the infant group (8.74%) was statistically higher than that (1.15%) in the elder group (P = 0.045). About 32.32% was cytomegalovi-rus-positive in the infant group while 2.35% in the elder group (P < 0.001). (4)The percentage of EB virus positive in infant group (4.04%) was statistically lower than that (14.12% ) in the elder patients(P - 0.016). (5) Both the median and the increase ratio of megakrocytes in infant group ( 144,81.7%) were statistically lower than that (280,96.6%) in the elder group (P = 0.005 ; P = 0.002). (6) Un-der the treatment of steroids only, the time for the platelet to become normal in infant group(7.1 ±2.6) was statistically shorter than that( 10.3±3.2) in the elder children(P< 0.001). Under the treatment of steroids plus IVIG, the time for the platelet to become normal in infant group (4.4±1.3) was statistically shorter than that (7.9±2.8) in the elder group (P < 0.001). The treatment efficacy by steroids plus IVIG in infant group was also statistically better than that in the elder group (P = 0.0075). Conclusion The characteristics of the infant patients with ITP are different from those of the elder patients. These include higher male/female ratio, different motivation and virus infection, fewer and lighter bleeding sites, lower number of megakrocytes in bone marrow, faster platelet count recovery, and most importantly, better treatment efficacy. Steroids plus IVIG treatment results in a faster recovery of platelets.