RETROSPECTIVE ANALYSIS OF 78 CHILDREN WITH CHRONIC IDIOPATHIC THROMBOCYTOPENIC PURPURA - FOLLOW-UP FROM 1976 TO 1996

In this retrospective study of 20 years, 78 children with chronic idio pathic thrombocytopenic purpura (ITP) were analyzed. Patients were fol lowed for 1-17 years (median 2.7 years). Every application that requir ed therapy was accepted as an ''attack.'' Seventy-eight patients recei ved therapy in 236 attacks. Immediate platelet responses to high-dose methylprednisolone (HDMP), prednisone, and splenectomy were 69.3% (in 53 patients), 48.3% (in 35 patients), and 84.6% (in 29 patients) of at tacks, respectively. Because 31 patients were lost to follow-up, the r ate of remission was calculated on the basis of 47 patients. The remis sion rates for patients who underwent remission spontaneously, after s teroid therapy, and after splenectomy were 29.78, 6.38, and 14.89%, re spectively. Of 78 adolescent patients, 11.5% had intracranial hemorrha ge (ICH), being after splenectomy. One patient died because of ICH. Th ese data indicate that chronic ITP is still a serious problem during a dolescence and splenectomy still seems to be a current choice of thera py.