Idiopathic thrombocytopenic purpura in children
نویسنده
چکیده
Idiopathic thrombocytopenic purpura (ITP) is the most common acquired bleeding disorder in childhood. ITP is characterized by a lo� circulating platelet count caused principally by destruction of antibody-coated platelets in the reticuloendothelial system. It can be classified into t�o major forms, acute and chronic. Acute ITP is usually a benign self-limiting condition �ith a high probability of spontaneous recovery. Rates of 80% complete remission can be achieved regardless of the treatment. Persistence of thrombocytopenia for more than 6 months defines the chronic form of the disorder, and is seen in approximately 20% of children. Children �ith chronic ITP also have a good prognosis, �ith up to 80% remissions over a period of years follo�ing diagnosis. The variability of clinical course makes the decision of �hether and ho� to treat difficult. Most children �ith ITP have mild bleeding symptoms and require no therapy. The commonly used regimens include corticosteroids and intravenous immunoglobulins. So far, there is no evidence that initial therapy can prevent major bleeding or a chronic course of the disease. ITP in childhood remains a disorder �ith many unsolved questions regarding pathophysiology, diagnostic approach and therapeutic decisions. Large prospective clinical trials �ith long-term follo�up are needed to define �hich subgroup of children �ith ITP should be treated �ith platelet-enhancing therapy.
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