Chronic immune thrombopenia

Classification according to ICD-10
D69.3	chronic immune thrombopenia
ICD-10 online (WHO version 2019)

As a chronic immune thrombocytopenia (ITP) in children is more describes the persistent isolated thrombocytopenia (<150 / nl) in otherwise healthy children than 6 months after diagnosis of acute ITP . Thrombocytopenias due to other causes must be ruled out: inherited, medicated, SLE , bone marrow dysfunction, HIV infection or other underlying diseases.

Epidemiology

After six months, 10–20%, after twelve months, 5–10% of all children with initially acute ITP still have thrombocytopenia. Girls' agility is not as pronounced in children as in adults. Remissions are possible at any time, up to 20 years after diagnosis. The remission rate is still around 61% after 15 years. Most children show a mild course.

Symptoms, degrees of severity

Mild: (> 90%) possibly petechiae or hematomas . Occasional slight bleeding from the mucous membrane with infections
Severe: (<10%) almost constantly impairing bleeding tendency
Life threatening bleeding

therapy

A causal therapy is not possible. Drugs that impair platelet function, such as acetylsalicylic acid and dangerous sports , should be avoided . Otherwise, similar rules apply as for acute ITP . In addition, immunosuppressants, cytostatics, a splenectomy (removal of the spleen) and other options that are individually selected depending on the situation of the individual patient are added in the event of severe disease.

literature

T. Inaba et al .: Eradication of Helicobacter pylori increases platelet count in patients with idiopathic thrombocytopenic purpura in Japan. In: Eur J Clin Invest. Volume 35, No. 3, Mar 2005, pp. 214-219. PMID 15733077

Individual evidence

^ MM Reid: Chronic idiopathic thrombocytopenic purpura: incidence, treatment and outcome. In: Arch Dis Child . (1995) 72, pp. 125-128. PMID 7702373 .
↑ R. Dickerhoff, G. Gaedicke: Guideline K4b: Chronic Immune Thrombocytopenia (ITP). (As of December 2006). In: German Society for Pediatrics and Adolescent Medicine: Guidelines for Pediatric and Adolescent Medicine. Urban & Fischer Verlag, ISBN 3-437-21869-7 .

[Reid-1] MM Reid: Chronic idiopathic thrombocytopenic purpura: incidence, treatment and outcome. In: Arch Dis Child . (1995) 72, pp. 125-128. PMID 7702373 .

[Dickerhoff-2] R. Dickerhoff, G. Gaedicke: Guideline K4b: Chronic Immune Thrombocytopenia (ITP). (As of December 2006). In: German Society for Pediatrics and Adolescent Medicine: Guidelines for Pediatric and Adolescent Medicine. Urban & Fischer Verlag, ISBN 3-437-21869-7 .