[Idiopathic thrombocytopenic purpura in childhood: retrospective analysis of the clinical prognosis].

To evaluate the relationship between initial therapy and clinical prognosis, retrospective analyses were performed in 73 children with idiopathic thrombocytopenic purpura treated in our hospital during the past 12 years. The patients were classified into three groups as follows: group A, 34 patients recovered from thrombocytopenia within six weeks after onset; group B, 9 patients recovered in a period of six weeks to six months; group C, 30 patients remained thrombocytopenia beyond six months. The majority of the patients in group A (82%) and group B (56%) provided a history of some infection within the preceding three weeks. The patients in group A and group B had epistaxis or purpura of mucous membranes more frequently than the patients in group C. Although, in group A and group B, steroid therapy and intravenous high-dose immunoglobulin (IVIG) therapy has been shown to rapidly increase platelet counts, many patients had become thrombocytopenia again from ten days after starting treatment. Therefore, there was no evidence that steroid therapy and IVIG therapy could reduce a total period of the thrombocytopenia compared with no treatment. The evidence suggested that those therapies, steroid therapy and IVIG therapy, might have influenced the essential natural history of the condition. The mean platelet associated IgG values in group C was significantly greater than in group A and group B with the platelet counts exceeds 100,000/microliters.