Evaluating the Treatment Indices of Immunologic Thrombocytopenic Purpura in Pediatric Patients

Mahdieh Saberi; Mehrdad Shekiba; Alireza Jenabzade; Hadi  Zare-Zardini

doi:10.18502/ijpho.v14i1.14662

Mahdieh Saberi Department of pediatrics, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Mehrdad Shekiba Department of pediatrics, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Alireza Jenabzade Hematology and Oncology Research Center, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
Hadi Zare-Zardini Hematology and Oncology Research Center, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

DOI: https://doi.org/10.18502/ijpho.v14i1.14662

Keywords: Chronic, Immunologic Thrombocytopenic Purpura, Medical Costs, Prognosis, Treatment Process.

Abstract

Background: Immunologic Thrombocytopenic Purpura (ITP) is considered as one of the common diseases among children. The aim of this study is evaluating the treatment indices of ITP in pediatric patients.

Materials and Methods: In this observational follow-up study, 123 ITP patients were assessed in term of medical history, physical examination, and laboratory tests based on the type of treatment.

Results: Among 123 ITP patients, 70 (56.9%) were female and 53 (43.1%) were male with mean age of 4 years. Considering the platelet count of > 20,000, 115 (93.6%), 4 (3.3%) were treated in less than a month (acute) and 1-6 months (sub-acute). Thirty two patients (26%) did not reach the normal platelet count in 6 months (chronic). IVG, steroid, RhoGAM, steroid+ IVIG, RhoGAM + IVIG, RhoGAM+steroid+IVIG therapy was done in 10.6, 15.4, 2.4, 41.5, 4.1, and 26, respectively. Three patients did not receive any medication. There was no significant relationship between the onset of clinical symptoms and the onset of treatment based on 20,000 platelet count; however, regarding the platelet count of 150000, the relationship was statistically significant. The frequency of ITP was higher in females. There was no report on Intra-cerebral hemorrhage (ICH). In addition, 11 patients (8.9%) were provided with splenectomy. The treatment with combinational therapy of RhoGAM and IVIG was regarded as the highest treatment rate. In addition, the highest length of hospotalization based on initial treatment belonged to steroid treatment followed by the combinational therapy of steroid and IVIG. The patients receiving IVIG were the ones with the highest cost for the first 24 hours of treatment, and regarding the later hospitalization, the patients treated with steroid and combinational therapy of steroid+IVIG had to pay the highest medical expenses.

Conclusion: No significant relationship between the symptoms, platelet count, and the type of treatment.