Lilleyman J S
University of Sheffield, Department of Paediatrics, Children's Hospital, Western Bank.
Arch Dis Child. 1994 Sep;71(3):251-3. doi: 10.1136/adc.71.3.251.
A UK survey was carried out to discover the frequency, circumstances, and outcome of intracranial haemorrhage (ICH) complicating idiopathic thrombocytopenic purpura (ITP) of childhood. A questionnaire was circulated through the membership of the UK Paediatric Haematology Forum, and thence to local paediatricians and haematologists. It sought information on any child with ITP who had had an ICH during the 20 year period to January 1994. Fourteen instances were discovered, seven before 1984 and seven after. Six children survived the event with minimal or no sequelae, four without craniotomy. An immediately precipitating cause was noted in four; two had arteriovenous malformations and two suffered head injuries. The event occurred over two weeks from diagnosis in seven cases and over two months in five. All children were profoundly thrombocytopenic at the time of their intracranial bleed. By calculation the 14 children would have represented some 0.1% of the total with ITP during the period under review. ICH in childhood ITP may have a precipitating cause and is not necessarily fatal. There is no period of maximum risk, and it can occur at any time during the course of the illness when the platelet count is less than 10-15 x 10(9)/l. It is an extremely rare event and previous estimates of its incidence may have been too high.
英国开展了一项调查，以了解儿童特发性血小板减少性紫癜（ITP）并发颅内出血（ICH）的频率、情况及后果。通过英国儿科学血液学论坛成员发放问卷，进而发给当地儿科医生和血液学家。问卷收集了1994年1月前20年期间患有ITP且发生ICH的儿童的相关信息。共发现14例，其中7例发生在1984年之前，7例在1984年之后。6名儿童在事件后存活，仅有轻微后遗症或无后遗症，4例未行开颅手术。4例发现有直接促发因素；2例有动静脉畸形，2例有头部受伤史。7例事件发生在诊断后两周内，5例发生在两个月以上。所有儿童颅内出血时血小板计数均极低。经计算，在研究期间，这14名儿童约占ITP患儿总数的0.1%。儿童ITP并发ICH可能有促发因素，不一定致命。没有最高风险期，在疾病过程中血小板计数低于10 - 15×10⁹/L的任何时候都可能发生。这是极其罕见的事件，之前对其发病率的估计可能过高。
