Idiopathic thrombocytopenic purpura (ITP) in childhood
Schaison, G.; Tobelem, G.
La Semaine des Hopitaux Organe Fonde Par l'Association d'Enseignement Medical des Hopitaux de Paris 57(25-28): 1238-1241
1981
ISSN/ISBN: 0037-1777 PMID: 6266047 Document Number: 181650
Half of thrombocytopenic purpuras occurs after a viral infection and is cured in a few weeks, but 10% of the cases are chronic. Toxic purpura is exceptional. Most of the cases are idiopathic. At the beginning it is impossible to foresee acute or chronic evolution. No treatment is necessary in ITP without serious bleeding. Prednisone does not avoid chronic state but shortened duration of acute ITP. Dosage is 1 mg/kg/day. Continuous corticotherapy is excluded in chronic ITP. Short corticotherapy is useful during bleeding periods. Splenectomy is to be considered after 6 or 12 months. Overall success raise 75%. Splenectomy is forbidden temporarily before 5 years, and definitely in immune deficiency. Immunosuppressive drugs are rarely used in childhood. Treatment with infusion of vincristine labeled platelets is in study. During the 18 months after cure, vaccinations must be avoided.