Department of Paediatric Haematology, Ain Shams University Cairo, 2 Sayed Zakaria Khalil, Morbah 1153, No 2 Elalfy, Cairo, Egypt.
Acta Haematol. 2010;123(1):59-63. doi: 10.1159/000262293. Epub 2009 Dec 2.
Intracranial hemorrhage (ICH) is a rare but major cause of death in immune thrombocytopenic purpura (ITP). The authors reviewed data of 1,840 patient with ITP, from 5 pediatric hematology centers in Egypt from 1997 to 2007, to study the incidence and risk factors of ICH. Ten cases of ICH were identified with a median age at presentation of 7.5 years; 4 patients had acute ITP, 2 persistent and 4 chronic. The platelet count was <10 x 10(9)/l in 7 cases, and only 1 patient had a history of head trauma. Seven children were on treatment prior to or at the time of occurrence of ICH and all were treated by pharmacotherapy. Two children died shortly afterwards due to late referral to a specialized center. Our results suggest that treatment does not prevent ICH and that it can occur at any time during the course of the disease. Delayed referral can be considered a risk factor for unfavorable outcome of ICH, highlighting the importance of teaching sessions for patients and their parents to minimize subsequent morbidity and mortality of ICH in children with ITP.
颅内出血（ICH）是免疫性血小板减少性紫癜（ITP）的一种罕见但严重的致死原因。作者回顾了 1997 年至 2007 年期间来自埃及 5 个儿科血液病中心的 1840 例 ITP 患者的数据，以研究 ICH 的发生率和危险因素。确定了 10 例 ICH，中位发病年龄为 7.5 岁；4 例为急性 ITP，2 例为持续性，4 例为慢性。7 例患者的血小板计数<10 x 10(9)/l，仅有 1 例有头部外伤史。ICH 发生前或发生时，7 名儿童正在接受治疗，所有儿童均接受药物治疗。随后有 2 名儿童因延迟转诊至专科中心而很快死亡。我们的结果表明，治疗并不能预防 ICH，并且它可能在疾病的任何时候发生。延迟转诊可被视为 ICH 不良结局的危险因素，突出了对患者及其父母进行教育的重要性，以尽量减少 ITP 儿童 ICH 的后续发病率和死亡率。
