Zafar Huma, Anwar Saadia, Faizan Mahwish, Riaz Shazia
Huma Zafar, FCPS. Department of Paediatric Haematology, Oncology and Bone Marrow Transplant, The Children's Hospital and the Institute of Child Health, Lahore, Pakistan.
Saadia Anwar, FCPS. Department of Paediatric Haematology, Oncology and Bone Marrow Transplant, The Children's Hospital and the Institute of Child Health, Lahore, Pakistan.
Pak J Med Sci. 2018 Sep-Oct;34(5):1195-1199. doi: 10.12669/pjms.345.15687.
The study aimed to demonstrate the pattern of clinical presentations and outcome of acute Immune Thrombocytopenia (ITP) in our Centre.
A descriptive, observational study was conducted by collecting and analysing the data of 103 patients of acute ITP, ageing between 1-14 years, at The Children's Hospital, Lahore from January 2016 to December 2016. We collected the data regarding age, sex, clinical presentations, history of preceding viral infections, vaccination history, laboratory values, different treatment options used, and response to the treatment concerning complete response, partial response and poor responders. Statistical analysis performed by using IBM SPSS statistics version 20.
We retrospectively, reviewed total 103 patients cases. The median age, at the time of presentation, was 5±3.4 years while mean age was 4.5±2.9 years. The male to female ratio was 1.28:1. Mean platelet count on presentation was 7 x 10/L (range: 0-24). Twenty three (22.3%), patients had the history of preceding illness. Bruises, petechiae, epistaxis and hematemesis remained the common presentations. Six (5.8%) patients showed spontaneous recovery while 97 (94%) patients received treatment for ITP. Overall, 71 (68.9%) showed a response after treatment. Sixty-two patients (59.22%) showed loss of response and received treatment again. Among these patients, thirty-four patients (33%) developed chronic disease.
Majority of patients presenting to our tertiary care centre had severe acute ITP on presentation. After management and follow-up, almost 1/3 of the patients develop chronic disease hence the incidence of developing chronic disease remained high as compared to the other centers.
本研究旨在展示我院中心急性免疫性血小板减少症（ITP）的临床表现模式及治疗结果。
2016年1月至2016年12月期间，在拉合尔儿童医院对103例年龄在1至14岁之间的急性ITP患者的数据进行收集和分析，开展了一项描述性观察性研究。我们收集了有关年龄、性别、临床表现、既往病毒感染史、疫苗接种史、实验室检查值、所采用的不同治疗方案以及治疗反应（完全缓解、部分缓解和无反应者）的数据。使用IBM SPSS statistics 20版本进行统计分析。
我们回顾性地分析了103例患者的病例。就诊时的中位年龄为5±3.4岁，平均年龄为4.5±2.9岁。男女比例为1.28:1。就诊时的平均血小板计数为7×10/L（范围：0 - 24）。23例（22.3%）患者有前驱疾病史。瘀斑、瘀点、鼻出血和呕血仍是常见表现。6例（5.8%）患者自发恢复，97例（94%）患者接受了ITP治疗。总体而言，71例（68.9%）患者治疗后有反应。62例患者（59.22%）反应消失并再次接受治疗。在这些患者中，34例（33%）发展为慢性病。
在我们的三级护理中心就诊的大多数患者初诊时患有严重急性ITP。经过治疗和随访，近三分之一的患者发展为慢性病，因此与其他中心相比，发展为慢性病的发生率仍然很高。
