B. Zeller et al., Immune thrombocytopenic purpura in childhood in Norway: A prospective, population-based registration, PED HEM ONC, 17(7), 2000, pp. 551-558
A prospective, population-based registration of children with immune thromb
ocytopenic purpura (ITP) was performed in Norway in 1996 and 1997. Ninety-t
wo cases were identified, indicating an incidence of 5.3 per 100, 000 child
ren under 15 years. The sex ratio (female/male) was 1.2/1. Fifty-six percen
t presented with cutaneous signs only. The lowest platelet count was < 20 x
10(9)/L. in 91 %. In spite of mild bleeding symptoms, medical treatment wa
s given in 68%, in most cases (57/63) with intravenous immunoglobulin. A to
tal of 41/44 patients with platelet counts of less than or equal to 5 x 10(
9)/L were treated, regardless of whether they had mucous bleedings or not.
Eighteen percent had platelet counts < 150 x 10(9)/L at 6 months, and 9% at
12 months following diagnosis. One patient with therapy-resistant chronic
ITP died 16 months after diagnosis from an anesthesia complication related
to profound epistaxis. This study shows a relatively high incidence. As in
other studies, there was a tendency to treat platelet counts rather than bl
eeding symptoms.