The study of 183 idiopathic thrombocytopenic purpura children treat at Hai Phong Children Hospital from 1/1998 to 4/2003. The disease is frequent in small children from 1 month to 5 years old in spring and winter, sex ratio is similar. Main manifestations were 95.6% spontaneous hemorrhage, fang hemorrhage 32%, nasal hemorrhage 12%. Polymorphic hemorrhage 60.44%, mild hemorrhage 55.7%. Main hematological sign was thrombocytopenia but it was not severe. Bleeding time was above 10 minutes in most of cases (57.38%). There were a correlation between platelet count and bleeding time
Diagnosis ; Hematology ; Purpura, Thrombocytopenic, Idiopathic ; Child

Hemorrhage ; Humans ; Purpura, Thrombocytopenic, Idiopathic ; diagnosis

Adult ; Humans ; Purpura, Thrombocytopenic, Idiopathic ; diagnosis ; therapy

The diversity of diagnostic criteria of idiopathic thrombocytopenic purpura (ITP) makes it difficult to compare clinical trial results and exchange clinical experiences. To address this issue, an ITP international working group convened a consensus conference in Italy in October 2007, and some new consensus concerning the terminology, definition, phases, grading of severity, prognosis, and treatment were achieved. The treatment of ITP has been dramatically improved along with the introduction of novel therapeutic agents. Rituximab, a monoclonal anti-CD20 antibody that is able to deplete autoantibody-producing B lymphocytes, has been widely applied because of its high efficacy and safety. Recent evidences suggest that decreased platelet production may also contribute to the development of ITP. Therefore, novel thrombopoiesis-stimulating agents such as thrombopoietin-receptor agonists Romiplostim and Eltrombopag have become new therapeutic options for ITP.
Humans ; Purpura, Thrombocytopenic, Idiopathic ; diagnosis ; therapy

Immune thrombocytopenia (ITP) is the most common cause of thrombocytopenia in children and can be defined as an autoimmune disorder of isolated thrombocytopenia without other causes of thrombocytopenia. This review will focus on the diagnostic approach of ITP, especially regarding the differential diagnosis. The practice of differential diagnosis has the goal of distinguishing primary ITP from secondary ITP and nonimmune thrombocytopenia requiring different treatments and showing different prognoses.
Child ; Diagnosis ; Diagnosis, Differential ; Humans ; Prognosis ; Purpura, Thrombocytopenic, Idiopathic* ; Thrombocytopenia

PURPOSE: It is well known that use of intranenous methylprednisolone(IVMP)for the patients with idiopathic thrombocytopenic purpura(ITP) is not only as effective as use of intravenous gammaglobulin to mincrease platelets quickly, but also the former is less expensive than the latter. As the adequate dosage of IVMP has not been fully elucidated, we have tried to determine it. METHODS: The subjects were 35 childhood patients below 15 years of age, who were diagnosed with ITP for the first time and whose platelet count was less than 20,000/mm(3) at diagnosis. We divided them into three groups : Group A included 8 cases with IVMP dosage of 5mg/kg/day, Group B included 9 patients with IVMP dosage of 10mg/kg/day, and group C included 18 patients with IVMP dosage of 20mg/kg/day. We checked the platelet count every day after IVMP administration daily for 5 days and also observed for side effects if any. RESULTS: After IVMP administration, we obseved increasing tendency of platelets in all three groups, of which group C was more rapid and higher in increasing platelets than the other groups(p<0.05). After IVMP therapy for 5 days, cases with platelets>20,000/mm(3) were 6(75%) in group A, 7(78%) in group B, and 18(100%) in group C. Cases with platelets >50,000/mm(3) were 5(63%), 6(67%), 17(94%) in groups A, B, C, respectively, and cases with platelets> 100,000/mm(3) were 3(38%), 5(56%), 14(78%), in group A, B, C, respectively. And there were no remarkable side effects except a case of transient hypertensive headache in group C. CONCLUSIONS: We concluded that the effectiveness of IVMP therapy for increasing platelets was more rapid and higher in group C than in group A or B, and side effect was minimal.
Child* ; Diagnosis ; Headache ; Humans ; Methylprednisolone* ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic*

Adult ; Female ; Humans ; Lymphoma, Non-Hodgkin ; diagnosis ; Pregnancy ; Pregnancy Complications ; diagnosis ; Purpura, Thrombocytopenic, Idiopathic ; diagnosis

PURPOSE: Mean platelet volume(MPV) and platelet distribution width(PDW) are useful parameters in evaluating disorders of platelets. In cases with idiopathic thrombocytopenic purpura(ITP), they change as platelet count increases. In this study, we compared the values of MPV and PDW in ITP patients at diagnosis with those of normal children. We also studied whether the early changes in MPV may predict the clinical course. METHODS: From December 1995 to May 2001, 71 patients with ITP were admitted to Ajou University Hospital. They were treated with IVIg 400 mg/kg for five days and MPV, PDW, platelet count were analysed. Normal control group(n=38) was compared. The study group was divided into acute and chronic forms, and also divided into group A, good early responders whose platelets increased more than 100,000/microL within 5 days and group B who did not. RESULTS: Mean value of MPV at diagnosis in ITP patients was lower than the normal control group(P<0.05). In group A, MPV was abruptly increased on the first day after IVIg and then started to decrease. But in group B, MPV was steadily increased until the fourth day after IVIg. In the normal control group, there were inverse correlations between platelet count and MPV(r= -0.415, P<0.05), but in ITP patients, there were positive relationships between platelet count and MPV(r=0.646, P<0.05) at diagnosis. CONCLUSIONS: MPV at diagnosis of ITP was lower than the normal control. MPV and PDW could not predict the course of ITP patients, but MPV could distinguish good early responders. More research is needed to find out the reasons of decreased MPV at diagnosis of ITP.
Blood Platelets* ; Child ; Diagnosis ; Humans ; Immunoglobulins, Intravenous ; Mean Platelet Volume* ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic*

A 34-year-old male presented with fluctuating diplopia, ptosis and motor weakness, who had been suffering from idiopathic thrombocytopenic purpura (ITP) and non-small cell lung cancer (NSCLC). Clinical and laboratory findings confirmed the diagnosis of generalized myasthenia gravis (MG). MG was successfully managed with pharmacologic treatments including an immunosuppressive agent. To the best of our knowledge, this is the first case of MG combined with ITP and NSCLC.
Adult ; Carcinoma, Non-Small-Cell Lung* ; Diagnosis ; Diplopia ; Humans ; Male ; Myasthenia Gravis* ; Purpura, Thrombocytopenic, Idiopathic*

BACKGROUND: Acute idiopathic thrombocytopenic purpura(ITP) in children has a low morbidity and mortality, and most of cases are self limited illness. But some of them are not responsive to treatment and finally progress to chronic disease. The purpose of this study is to evaluate the factors which influence the outcome in childhood idiopathic thrombocytopenic purpura. METHOD: From January 1990 to December 1995, patients with ITP who were admitted to the Pediatric department of Pusan National University Hospital were divided into acute and chronic form depending on whether the platelet count had returned to normal(150 x 10(9)/1) by six months after diagnosis. Between two groups, the clinical and laboratory characteristics, response to treatment were compared. RESULT: 1) Out of 55 patients with ITP, 36 cases(65.5%) were acute and 19 cases(34.5%) were chronic ITP. 2) Sex, previous viral infection history, clinical manifestations were not significantly different between two groups, but the chronic ITP was rare in less than 1 year of age. 3) The duration of symptoms over >2 weeks at presentation was strongly predictive of chronic ITP. 4) Most of chronic disease (87.5%) showed platelet counts below 150 x 10(9)/1 at 28 days after diagnosis as compared with acute disease(25.0%). 5) Among 19 cases of chronic disease, 6 cases responded completely to treatment, but 11 cases(57.9%) did not respond to any treatments, 2 cases improved spontaneously. CONCLUSION: A history of symptoms over 2 weeks at presentation and platelet counts below 150 x 10(9)/1 at 28 days after diagnosis were strong predictors of chronic ITP in children.
Busan ; Child ; Chronic Disease ; Diagnosis ; Humans ; Mortality ; Platelet Count ; Purpura, Thrombocytopenic, Idiopathic*