Lee Anselm Chi-Wai
Children's Haematology and Cancer Centre, Mount Elizabeth Hospital, Singapore.
Singapore Med J. 2025 Jan 1;66(1):20-23. doi: 10.4103/singaporemedj.SMJ-2021-184. Epub 2023 Mar 2.
Immune thrombocytopenia (ITP) is the most common cause of acquired bleeding in childhood, but little is known about the clinical course and outcomes in infants with ITP.
This is a retrospective study of all infants (1-12 months of age) and toddlers (13-47 months of age) diagnosed with ITP from a single centre during a 13-year period. The following data were compared between the two patients groups: demographics, severity of bleeding, platelet counts, duration of illness, development of chronic ITP, treatment and association with recent vaccination.
Twenty-two infants and 30 toddlers were diagnosed and followed up for ITP during the study period. Infants with ITP generally had minor or mild bleeding (19, 86.4%) and seldom required treatment (7, 31.8%), and their thrombocytopenia resolved at a mean of 1.90 months after diagnosis. Besides age, the sex ratio, severity of bleeding, platelet counts and proportion that required treatment were comparable between infants and toddlers. Fewer infants developed chronic ITP (1/22 vs. 9/30, P = 0.032), but more infants had a history of vaccination in the preceding 6 weeks prior to diagnosis of ITP (13/22 vs. 1/30, P < 0.001).
ITP in infants is almost always a self-limiting and transient illness, and the majority of cases do not require treatment.
免疫性血小板减少症(ITP)是儿童后天性出血最常见的原因,但对于婴儿ITP的临床病程和结局知之甚少。
这是一项对13年间在单一中心诊断为ITP的所有婴儿(1至12个月大)和幼儿(13至47个月大)进行的回顾性研究。比较了两组患者的以下数据:人口统计学、出血严重程度、血小板计数、病程、慢性ITP的发生情况、治疗以及与近期疫苗接种的关联。
在研究期间,22名婴儿和30名幼儿被诊断为ITP并接受随访。ITP婴儿通常有轻微或轻度出血(19例,86.4%),很少需要治疗(7例,31.8%),其血小板减少症在诊断后平均1.90个月缓解。除年龄外,婴儿和幼儿之间的性别比例、出血严重程度、血小板计数以及需要治疗的比例相当。发展为慢性ITP的婴儿较少(1/22 vs. 9/30,P = 0.032),但更多婴儿在诊断ITP前6周内有疫苗接种史(13/22 vs. 1/30,P < 0.001)。
婴儿ITP几乎总是一种自限性和短暂性疾病,大多数病例无需治疗。