Clinical and laboratory analysis of children who follow up with thrombocytopenia: A retrospective study

Abstract

Introduction: Platelets are cells that play an important role in the first phase of hemostasis, where the clot plug is formed. Disorders in the number or function of platelets can lead to bleeding. While many conditions are responsible for the etiology thrombocytopenia in childhood, the most common cause is immune thrombocytopenia. The aim of the study was to investigate the causes, evaluate treatment and follow-up strategies, and reduce delays in diagnosis and treatment in children who develop thrombocytopenia. Materials and Methods: In our study, 1500 patients who applied to our clinic between January 2010 and December 2015 and were given at least one of the ICD codes D69.3, D69.4, D69.5, and D69.6 were evaluated. When patients who did not meet the inclusion criteria were excluded from the study, a total of 440 patients were asked to fill out the thrombocytopenia form. Results: In our study, the incidence of thrombocytopenia was 8.4: 100.000, and the incidence of ITP was 5.1. 59% of patients were male, and 41% were female. The mean age was 6.6 +/- 2.1 years. The most common cause of thrombocytopenia was found to immune thrombocytopenia (ITP). 49.2% of ITP patients had a history of upper respiratory tract infection. 40 patients had a history of vaccination within the last 6 weeks. Drug-induced thrombocytopenia was detected in 10.5% of & Idot;TP patients. It was seen that 6.1% of all patients were in the neonatal period. Treatment was given to 53.1% of ITP patients. The response time to intravenous immunoglobulin and steroid treatments was 36.8 +/- 1.2 and 63.2 +/- 1.2 hours, respectively. Platelet recovery time was between months in 80.6% of ITP patients. Of the 36 chronic & Idot;TP patients, 25 had primary ITP, and 11 had secondary ITP. Conclusion: Thrombocytopenia is a rare laboratory result in childhood. In patients with thrombocytopenia, detailed history, physical examination, and correct laboratory tests can be used to detect congenital thrombocytopenia syndromes, leukemia, & Idot;TP, aplastic anemia or underlying infections, and solid malignancies. Considering that platelet levels return to normal spontaneously the first three months without developing complications in most patients, it is important to apply the "watch and wait" strategy appropriate patients.