Verissimo Vanessa, Carter Tina, Wright Helen, Robertson Jeremy, Osborn Michael, Bradbeer Peter, Sabesan Vanaja, Saxon Ben, Barbaro Pasquale, Crighton Gemma, Chamberlain Janis, Zheng Silvia, Freeman Kate
Haematology Department, Perth Children's Hospital, Perth, Western Australia, Australia.
Department of Haematology, PathWest, Nedlands, Western Australia, Australia.
J Paediatr Child Health. 2023 May;59(5):711-717. doi: 10.1111/jpc.16395. Epub 2023 Apr 18.
In children, the majority of cases are self-limiting and thus many paediatric patients can be managed conservatively with minimal complications. This varies considerably compared to adult newly diagnosed immune thrombocytopaenia (NDITP) where, in most cases, thrombocytopaenia persists with higher risk of moderate to severe bleeding complications. In the past decade, local and international guidelines have emerged to support approaches to the investigation and management of NDITP, with a focus primarily on adult immune thrombocytopaenia (ITP). International consensus guidelines on paediatric NDITP have been developed, however gaps remain, and approaches vary between North American, Asia, Europe and the UK. There are no current Australian or New Zealand paediatric ITP guidelines readily available, rather differing guidelines for each state, territory or island. These inconsistencies cause uncertainty for patients, families and physicians managing cases. Subsequently, physicians, including paediatric haematologists and general paediatricians, have come together to provide a consensus approach guideline specific to paediatric NDITP for Australian or New Zealand. Persistent or chronic paediatric ITP remains a complex and separate entity and are not discussed here.
在儿童中,大多数病例是自限性的,因此许多儿科患者可以采用保守治疗,并发症极少。与成人新诊断免疫性血小板减少症(NDITP)相比,情况差异很大,在成人中,大多数情况下血小板减少症会持续存在,发生中度至重度出血并发症的风险更高。在过去十年中,已经出现了支持NDITP调查和管理方法的本地和国际指南,主要侧重于成人免疫性血小板减少症(ITP)。关于儿科NDITP的国际共识指南已经制定,但仍存在差距,北美、亚洲、欧洲和英国的方法各不相同。目前没有现成的澳大利亚或新西兰儿科ITP指南,每个州、领地或岛屿的指南都有所不同。这些不一致给管理病例的患者、家庭和医生带来了不确定性。随后,包括儿科血液学家和普通儿科医生在内的医生们共同为澳大利亚或新西兰制定了一份针对儿科NDITP的共识方法指南。持续性或慢性儿科ITP仍然是一个复杂且独立的实体,本文不对此进行讨论。