Clinical Features and Treatment Outcomes of 132 Infants with Immune Thrombocytopenic Purpura

Introduction: To determine common clinical symptoms, admission length, and treatment outcomes of infants with Immune Thrombocytopenic Purpura.
Method: analysis of 132 infants with Immune Thrombocytopenic Purpura admitted to the emergency and hematology ward of Dr. Sheikh Hospital, with reference to age, gender, immunization history (preceding six weeks), presenting clinical features, treatment, outcome, platelet count at admission and discharge time, admission length, and records of respiratory infections, diarrhea and vomiting in the past month.
Results: 82 male and 50 female infants aged from five day to 2 years, with the median age of 163 days were observed. 49 percent of the patients had positive vaccination records during past 6 weeks. Presenting clinical symptom in order of commonality include: petechial rash (75%), gastrointestinal bleeding (8%), epistaxis (7%),  gum bleeding (4%), and brain hemorrhage (2%). The average platelet count at admission time and discharge time was reported 10,000 ml. and 135,000 ml. respectively. 47% of the patients were treated with intravenous methylprednisolone, 16% with oral prednisolone, 12% with intravenous gamma globulin (IVIG), 7.5% with intravenous dexamethasone, 5% with IVIG. 6% received IVIG plus oral prednisolone, and for 5% IVIG and intravenous dexamethasone was administered. 93% of the patients completely recovered, 3% developed recurrent ITP, and 4% developed chronic ITP. Average admission length was reported to be 4 days. 34% of the patients had upper respiratory tract infection history, and 4.5% had positive diarrhea record.
Conclusion: infants with ITP aged under 2 years respond favorably to treatment, and compared to older age groups, are less likely to develop recurrent and chronic ITP.