Treatment Outcomes of Pediatric Newly Diagnosed Immune Thrombocytopenia in Ratchaburi Hospital
Keywords:
immune thrombocytopenia, complete response time, incidence of chronic immune thrombocytopeniaAbstract
Objective: The purpose was to determine the clinical outcomes of pediatric patients with newly diagnosed immune thrombocytopenia (nITP) and the incidence of chronic immune thrombocytopenia (cITP) in each of treatment regimens.
Methods: We retrospectively collected and analyzed the data from medical records of the nITP pediatric patients (3 months to 15 years old) from 1 August 2015 to 31 July 2022 in Ratchaburi Hospital.
Results: A total of 86 children with newly diagnosed were enrolled. The male to female ratio was 1.3:1. The median age at presentation was 4 years and 5 months (0.3–13.3 years). History of infection and vaccination before ITP diagnosis was 20.9% and 8.1% respectively. More than half of the patients had grade 1 and 2 bleeding severity scale. The median platelet count at diagnosis was 7 x 109/L (2–98 x 109/L). The patients’ treatments were categorized into 5 groups: Observation group (7%), prednisolone 1–2 mg/kg/day (Pred 2) group (20.9%), prednisolone 4 mg/kg/day (Pred 4) group (11.6%), pulse methylprednisolone (MP) group (48.8%), and intravenous immunoglobulin (IVIg) group (11.6%). Regarding to the study, IVIg group had the shortest complete response time. Statistically significant data were shown between IVIg group and Observation group (p-value = .008); but there’s no statistically significant difference among Observation group and Pred 2, Pred 4, and MP group (p-value = .061, .487, and .250 respectively). After 1-year follow-up, 50% of patients in the Observation group, 33% in the Pred 2 group, 20% in the Pred 4 group, 11.9% in the MP group, and 10% in the IVIg group turned into chronic ITP. The incidence of chronic ITP revealed no statistically significant difference among treatment groups (p-value = .079).
Conclusion: The treatment outcomes of newly diagnosed ITP were different in each treatment. The patients in IVIg group had the shortest complete response time. The most incidence of chronic ITP were found in Observation group. From the study, we can conclude that the results can be useful for choosing the treatment properly for the patients.
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ลิขสิทธิ์บทความเป็นของผู้เขียนบทความ แต่หากผลงานของท่านได้รับการพิจารณาตีพิมพ์ลงวารสารแพทย์เขต 4-5 จะคงไว้ซึ่งสิทธิ์ในการตีพิมพ์ครั้งแรกด้วยเหตุที่บทความจะปรากฎในวารสารที่เข้าถึงได้ จึงอนุญาตให้นำบทความในวารสารไปใช้ประโยชน์ได้ในเชิงวิชาการโดยจำเป็นต้องมีการอ้างอิงถึงชื่อวารสารอย่างถูกต้อง แต่ไม่อนุญาตให้นำไปใช้ในเชิงพาณิชย์
