Feride Çeliker AKYÜZ, Selvi KELEKÇİ, Murat SÖKER, Müsemma KARABEL, Velat ŞEN, Veysiye Hülya ÜZEL, İlyas YOLBAŞ, Ali GÜNEŞ

İmmün Trombositopenik Purpura Olgularımızın Değerlendirilmesi: Tek Merkez Deneyimi

Amaç: Akut immün trombositopenik purpura çocukluk çağında ciddi organ kanamaları ve kronikleşme riskinden dolayı hala önemini koruyan önemli bir hastalıktır. Bölgemizdeki immun trombositopenik purpura olgularını klinik özellikleri ve farklı tedavi metotlarına ve yaklaşımlarına verdikleri yanıtlar bakımından retrospektif olarak inceledik. Gereç ve Yöntem: Çalışmada akut ve kronik gidişli immün trombositopenik purpuralı olgular, iki yaş altı ve iki yaş üzerindeki olgular ilk başvuru semptomları, muayene bulguları ve almış oldukları tedavi seçeneklerine verdikleri yanıt bakımından karşılaştırıldı. Bulgular: Çalışmaya dahi edilen olguların 78 tanesi erkek, 73 tanesi kız, ortalama yaş 5,1±3,4/yıl ve %75 akut, %25 olgu kronik immun trombositopenik purpura tanısı ile izlenmişti. İki yaşından büyük olguların kronikleşmeye gidiş oranı, iki yaşından küçük gruba göre daha yüksek bulundu (p=0.01). Olgular en sık cilt bulguları ile hastaneye başvurmuş ve semptomları daha az belirgin olan olguların %64,6'sı kronikleşmişti. Mevsim ve cinsiyet faktörü akut-kronik immun trombositopenik purpura olmayı etkilemediği saptandı (p=0.119 ve p=0.061). İlk tedavide steroid alan ve tedavi sonunda parsiyel remisyon gerçekleşen hastalarının kronikleşme oranı (p=0.001) ve akut olguların steroide olumlu yanıt oranı yüksekti (p=0.04). Sonuç: Olgularımızın klinik özellikleri ülkemizdeki diğer bildirilmiş immun trombositopenik purpura olgularına paralellik göstermekte olup ekonomik ve etkili tedavi seçimlerinin hastalığa bağlı morbidite ve mortaliteyi önleyerek hasta prognozuna olumlu katkı sağlayacağı düşünülmektedir. Anahtar kelimeler: İTP; çocuk; tedavi.

Anahtar Kelimeler:

İTP; çocuk; tedavi.

Evaluation of Immune Thrombocytopenic Purpura Cases: A Single Center Experience

Aim: Due to risk of severe bleeding of the organs and inveteracy acute immune thrombocytopenic purpura (ITP) is a disease that still preserves importance. In our region, cases of ITP retrospectively reviewed in terms of clinical characteristics and responses to the treatment options. Matarial and Methods: Acute and chronic cases, patients who are presenting symptoms over the age of two years and under two years of age were compared in terms of symptoms, examination findings and responses to the treatment options. Results: A total of 151 patients (male n=78, female n=73) and mean age was 5.1±3.4 years were included. The ratios of acute and chronic patients' were 75% and 25%, retrospectively. Chronicity rate was higher in patients more than two years age (p=0.01). The most frequently presenting symptom was skin lesions and 64.6% of patients with silent symptoms developed chronic immune thrombocytopenic purpura. Seasonal factors and gender had no effect on acute and chronic immune thrombocytopenic purpura (p=0.119, p=0.061). The chronicity rate of patients who have partial remission at the end of the steroid treatment as a first-line treatment option was found (p=0.001). In acute ITP cases high rate of positive response was found to steroid therapy (p=0.04). Conclusions: The clinical characteristics of the patients in our region are similar to other reported cases in our country. Economic and effective treatment selection to preventing morbidity and mortality due to disease in patients was thought to make a positive contribution of the disease prognosis. Key words: ITP; Childhood; Treatment.

Keywords:

ITP; Childhood; Treatment.,

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Başvuru Tarihi: 16.01.2013, Kabul Tarihi: 14.03.2013
Correspondence / İletişim 0 For citing/ Atıf için:
Feride ÇELİKER AKYÜZ
Diyarbakır Çocuk Hastanesi, Çocuk Sağlığı ve Hastalıkları, DİYARBAKIR TÜRKIYE
E—mail: feride©gmail.com
AkyUz FC, Kelekci S, Soker M, Karabel M, Sen V, Uzel VH,
Yolbaş I, Gunes A. Evaluation of immune thrombocytopenic
purpura cases: a single center experience. J Turgut Ozal
Med Cent 2013;20(3):246—251 DOI: 10.7247/jtomc.20.3.11