Goţia S, Moraru E, Rugină A, Iliescu C, Georgescu D
Clinica a II-a Pediatrie, Facultatea de Medicină, Universitatea de Medicină şi Farmacie Gr. T. Popa, Iaşi.
Rev Med Chir Soc Med Nat Iasi. 1999 Jan-Jun;103(1-2):124-30.
In infant and young children (1-3 yrs), I.T.P. (idiopathic thrombocytopenic purpura) is an acute, self-limited disease in 6 months since the diagnosis. The treatment with intravenous immunoglobulins or corticosteroids will be administered in severe forms of disease(predicted by the severity of hemorrhage and thrombocytes less than 10 G./l). A retrospective study of 29 cases with I.T.P. in infants and young children shows that 22 out of 29 were acute I.T.P., 7 out of 29 were recurrent I.T.P., in which 3 cases were chronic I.T.P. Post-hemorrhage associated anemia was present in 10 out of 29 cases, in which 3 cases was severe. Prolonged bleeding time appears only in severe I.T.P. Values of thrombocytes less than 10 G/l were met in 6 cases of acute I.T.P. and in 3 cases with recurrent I.T.P., there was no predictable correlation between the very low value in the time of diagnosis and the following clinical course of the disease. Neonatal I.T.P. (history of maternal I.T.P) had a favourable clinical course after i.v. immunoglobulins treatment (1 case) and a trend to chronicity (1 case) probably due to platelet antiphospholipid antibodies. Postvaccinal I.T.P. is a rare and benign complication. Only 5 of 29 cases had spontaneous remission. The clinical course was towards complete remission in 22 out of 29 cases with i.v. immunoglobulins and/or corticosteroid therapy. In conclusion, view the natural history of disease and the unvariables responses to treatment, spontaneous bleeding cannot be predicted only by platelet count in I.T.P.-Infant-low age (1-3 yrs).
在婴幼儿（1 - 3岁）中，特发性血小板减少性紫癜（ITP）在诊断后的6个月内是一种急性自限性疾病。对于严重形式的疾病（根据出血严重程度和血小板计数低于10 G./l预测），将采用静脉注射免疫球蛋白或皮质类固醇进行治疗。一项对29例婴幼儿ITP病例的回顾性研究表明，29例中有22例为急性ITP，29例中有7例为复发性ITP，其中3例为慢性ITP。29例中有10例出现出血后相关性贫血，其中3例严重。延长的出血时间仅出现在严重ITP中。6例急性ITP和3例复发性ITP病例的血小板计数低于10 G/l，诊断时的极低值与疾病随后的临床病程之间没有可预测的相关性。新生儿ITP（母亲有ITP病史）在静脉注射免疫球蛋白治疗后临床病程良好（1例），有1例可能由于血小板抗磷脂抗体而有慢性化趋势。疫苗接种后ITP是一种罕见的良性并发症。29例中只有5例自发缓解。29例中有22例在接受静脉注射免疫球蛋白和/或皮质类固醇治疗后临床病程趋向完全缓解。总之，鉴于疾病的自然病程和对治疗的多变反应，在低龄（1 - 3岁）婴幼儿ITP中，仅通过血小板计数无法预测自发性出血。
