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Original Article
Clinical Features and Treatment Outcomes of Immune Thrombocytopenic Purpura in Infants: A Single Center Retrospective Study
Clin Pediatr Hematol Oncol 2019;26:77-82.
Published online October 31, 2019
© 2019 Korean Society of Pediatric Hematology-Oncology and Korean Society for Pediatric Neuro-Oncology

Sang Jun Sohn, Kyung Mi Park, Eu Jeen Yang and Young Tak Lim

Department of Pediatrics, Pusan National University School of Medicines, Yangsan, Korea
Correspondence to: Young Tak Lim
Department of Pediatrics, Pusan National University School of Medicine, 20 Geumo-ro, Meulgeum-eup, Yangsan 50612, Korea
Tel: +82-55-360-3165
Fax: +82-55-360-2181
E-mail: limyt@pusan.ac.kr
ORCID ID: orcid.org/0000-0002-3300-7239
Received September 16, 2019; Revised October 7, 2019; Accepted October 14, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Immune thrombocytopenic purpura (ITP) in children less than one year of age is less well characterized compared to ITP in toddlers and school-age children. Since children of different ages may have differing clinical courses, better delineation of the natural history of ITP in infants is needed.
Methods: We retrospectively reviewed the admission records of 248 consecutive pediatric patients between 1 month and 15 years of age who were admitted and treated for acute ITP at Pusan National University Children’s Hospital from 2009 through 2017. All patients less than 1 year of age were identified and enrolled in this study. We investigated their demographics, clinical features, laboratory examinations, response to treatment, and long-term outcomes and made a comparison to those of children aged 1 to 10 years of age.
Results: Ninety nine infants were identified. Male to female ratio was highest in infants and decreased with age. Seventy nine (79.8%) of the 99 infant were found to be under 6 months old. The median platelet counts at diagnosis was 6×109/L. Minor bleeding (bleeding score 0-2) was significantly dominant in infant compared to older subjects. Eighty two (96.5%) out of 85 patients achieved complete remission after initial intravenous immunoglobulin (IVIG) treatment. The relapse rate after initial CR was significantly lower than older ages (P=0.003). The platelet count after IVIG treatment in infant showed more rapid response compared to older subjects (P=0.04). Follow up information at 12 months was available for 70 infants. Chronic ITP at 12 month was seen less frequently in infants than in children 1 to 10 years of age (1.4% vs. 20.2%, P<0.001).
Conclusion: Infants with acute ITP respond more favorably to IVIG treatment and are less likely to develop chronic ITP compared to children 1 to 10 years of age.
Keywords: Immune thrombocytopenic purpura, Infants, Chronic
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October 2019, 26 (2)
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Author ORCID Information
  • Young Tak Lim 

Funding Information
  • Pusan National University Yangsan Hospital