Department of Pediatric Hematology/Oncology, Hadassah Hebrew-University Hospital, Jerusalem, Israel.
J Pediatr. 2013 Nov;163(5):1335-9.e1-2. doi: 10.1016/j.jpeds.2013.06.018. Epub 2013 Jul 25.
To evaluate the predictive value of clinical features at diagnosis of immune thrombocytopenia (ITP) for resolution of disease.
Hospital records of 472 consecutive children (<18 years old) with ITP cared for at 2 participating centers were reviewed retrospectively and data related to the initial presentation were recorded. Logistic regression analysis was used for calculating prediction of resolution at 3, 6, and 12 months from diagnosis.
The most significant predictors for resolution of ITP at 3, 6, and 12 months were age at onset <10 years and abrupt onset (history of <2 weeks of bleeding). We designed a prediction rule for ITP chronicity based on these criteria. The rate of developing chronic ITP for low, intermediate, and high risk children at diagnosis of ITP was 11%, 39%, and 63%, respectively. Recovery rate at 3 months for low, intermediate, and high risk children was 72%, 43% and 30%, respectively.
We present a simple rule to predict recovery from ITP at 3, 6, and 12 months from diagnosis. For prediction of resolution at 3 months, our rule was in agreement with the more complex, previously described Nordic score. Prediction of resolution of ITP may enable practitioners to better inform children and parents at the time of diagnosis, resulting in reduced anxiety and improved quality of life.
评估免疫性血小板减少症 (ITP) 诊断时的临床特征对疾病缓解的预测价值。
回顾性分析了 2 个参与中心收治的 472 例连续儿童 (<18 岁) 的 ITP 病例的医院记录，并记录了与初始表现相关的数据。采用逻辑回归分析计算从诊断后 3、6 和 12 个月的缓解预测。
缓解 ITP 的最显著预测因素是发病年龄 <10 岁和突然发病（<2 周的出血史）。我们根据这些标准设计了一种 ITP 慢性预测规则。低、中、高危儿童在 ITP 诊断时发展为慢性 ITP 的发生率分别为 11%、39%和 63%。低、中、高危儿童在 3 个月时的恢复率分别为 72%、43%和 30%。
我们提出了一种简单的规则来预测从诊断开始后 3、6 和 12 个月的 ITP 缓解。对于 3 个月时的缓解预测，我们的规则与之前描述的更复杂的北欧评分一致。ITP 缓解的预测可能使医生在诊断时更好地告知儿童及其家长，从而减轻焦虑并提高生活质量。
