Department of Pediatrics, Hematology/Oncology Section, Baylor College of Medicine, Houston, TX.
Hematology Am Soc Hematol Educ Program. 2018 Nov 30;2018(1):405-411. doi: 10.1182/asheducation-2018.1.405.
Immune thrombocytopenia (ITP) has historically been thought to occur in 2 distinct forms: childhood ITP and adult ITP. This division is based largely on the presumption that childhood ITP is often benign and self-limited, whereas ITP in adults tends to be more chronic and difficult to treat. Although data exist to justify a different approach to the diagnosis and treatment in young children and the elderly, ITP in older children, adolescents, and younger adults is likely to share more similar pathology. This article will highlight the most recent data describing the natural history, diagnostic approach, management strategies, and disease-related outcomes in children and adults with ITP. These data reveal many unexpected similarities between the 2 groups, while confirming some of the more well-described differences. Discussion of these findings aims to highlight similarities and differences between ITP in children and adults, which will underscore important areas of future research and/or changes in management guidelines.
免疫性血小板减少症 (ITP) 既往被认为存在 2 种不同形式:儿童 ITP 和成人 ITP。这种划分主要基于这样一种假设,即儿童 ITP 通常是良性且自限性的,而成人 ITP 往往更慢性且难以治疗。尽管有数据支持对幼儿和老年人采取不同的诊断和治疗方法,但年龄较大的儿童、青少年和年轻成年人的 ITP 可能具有更多相似的病理。本文将重点介绍描述儿童和成人 ITP 的自然病史、诊断方法、管理策略和疾病相关结局的最新数据。这些数据揭示了这 2 组之间许多出人意料的相似之处,同时也证实了一些更为人熟知的差异。讨论这些发现旨在突出儿童和成人 ITP 之间的相似点和不同点,这将突出未来研究和/或管理指南变化的重要领域。