Selçuk ERDOĞAN, Tuba KASAP, Şahin TAKÇI, Ali GÜL, Ergün SÖNMEZGÖZ, Erhan KARAASLAN, Rüveyda GÜMÜŞER, Osman DEMİR

Pediatrik İmmün Trombositopeni (İTP) Vakalarının ve Kronik İTP için Risk Faktörlerinin Değerlendirilmesi - Tek Merkez Deneyimi

Amaç: İmmün trombositopeni (İTP) çocukluk çağının en sık görülen edinilmiş kanama bozukluğudur. Bu çalışmada, pediatrik İTP vakalarında demografik ve klinik özellikler ile tedavi yanıtlarının incelenmesi ve bunların kronikleşmeye olan etkilerinin değerlendirilmesi amaçlandı. Gereç ve Yöntemler: Ocak 2010 ve Aralık 2018 tarihleri arasında Tokat Gaziosmanpaşa Üniversitesi Hastanesi Çocuk Sağlığı ve Hastalıkları Kliniği'nde tanı alan ve takip edilen, 1 ay ile 18 yaş arası primer İTP hastaları geriye dönük olarak incelendi. Bulgular: Primer İTP tanısı olan 38 hasta bu çalışmaya dahil edildi. Hastaların yaş ortalaması 94,3±53,4 (14-199) ay idi. Kız/erkek oranı 1 idi. 20 (%57,1) hastada akut İTP, 15 (%42,9) hastada kronik İTP vardı. Akut İTP grubu ile kronik İTP grubu arasında demografik, klinik özellikler, laboratuvar bulguları ve tedavi yanıtları açısından anlamlı bir farklılık yoktu. İlk 12 ayda trombosit sayısı <20.000 /mm3 olan başvuru sayısı, tedavi gerektiren başvuru sayısı ve takipte tedavi verilme oranı kronik İTP grubunda anlamlı olarak daha yüksekti (sırasıyla, p=0.001, p=0.001 ve p<0.001). Sonuç: Çocuklarda primer İTP’de kronikleşme için risk faktörlerinin bilinmesi, yüksek riskli hastaların tanımlanarak takip ve tedavinin planlanmasına, gereksiz girişimlerin, hasta ve ailesinde meydana gelebilecek anksiyetenin önüne geçilmesine yardımcı olacaktır. Bu çalışmanın sonuçlarına göre, İTP hastalarında tanı sonrası ilk bir yıl içinde trombositopeni ataklarının sık görülmesi, kronik İTP için bir belirteç olarak kabul edilebilir.

Anahtar Kelimeler:

çocuk, akut immün trombositopeni, kronik immün trombositopeni, risk faktörleri

Evaluation of Pediatric Immune Thrombocytopenia (ITP) Cases and Risk Factors for Chronic ITP - Single Center Experience

Aim: Immune thrombocytopenia (ITP) is the most common acquired bleeding disorder in childhood. The study aimed to assess the demographic and clinical characteristics, and treatment responses and to evaluate their effects on chronicity in pediatric ITP cases. Material and Methods: Primary ITP patients aged 1 month to 18 years, who were diagnosed and followed up in the Pediatrics Clinic of Tokat Gaziosmanpaşa University Hospital between January 2010 and December 2018, were retrospectively analyzed. Results: Thirty-eight patients with a diagnosis of primary ITP were included in the study. The mean age of the patients was 94.3±53.4 (14-199) months. The female/male ratio was 1. Twenty (57.1%) patients had acute ITP, and 15 (42.9%) patients had chronic ITP. There was no significant difference between the acute ITP group and the chronic ITP group in demographic, clinical features, laboratory findings, and treatment responses. In the first 12 months, the number of admissions with a platelet count of <20 000 /mm3, the number of admissions requiring treatment, and the rate of treatment given during follow-up were significantly higher in the chronic ITP group (p=0.001, p=0.001, and p<0.001, respectively). Conclusion: To be aware of the risk factors for the development of chronic ITP will lead to the identification of high-risk patients, decisions about treatment and follow-up, and prevent unnecessary interventions and anxiety that may occur in the patient and his/her family. According to the results of this study, frequent relapses in the first year after the diagnosis of ITP may be considered a marker for chronic ITP.

Keywords:

child, acute immune thrombocytopenia, chronic immune thrombocytopenia, risk factors,

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