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CLINICAL PREDICTORS OF CHRONIC IMMUNE THROMBOCYTOPENIA ITP AMONG ADULTS AND CHILDREN

Abdulkareem Alhejaili, Yazeed Alqurashi, Amjad Alsoraihi, Fayssal Farahat, Enaam Alsobhi, Abdullah Baothman

Introduction: Immune thrombocytopenia (ITP) is defined as an isolated platelet count lower than 100 × 109/L in the absence of preexisting diseases or conditions that could lead to thrombocytopenia (1,2). Although several factors influence the outcome, it is difficult to predict at diagnosis which patients will have the acute or chronic form of the disease (3,4). Therefore, we aim in this study to identify the clinical presentation of the disease, predictors of chronicity, and modalities of treatment given in the child and adult population at King Abdulaziz Medical City, Jeddah.Methods: We retrospectively reviewed the records of patients diagnosed with ITP between 1993 and 2017. Files were collected from a total of 185 patients, of whom 94 with primary ITP were included in the study.Results: Most patients were females (58.5%). Median age at diagnosis of ITP for patients above 14 years old was 29 years (IQR 32) and for pediatrics (≤14 years old) was 4 years (IQR 6). Mean platelet count at presentation was 20.02 × 109/L ( SD 23.270). The most common presentation was skin manifestation (51.1%) followed by bleeding ( 17% epistaxis, 13.8% bleeding gums, 3.2% gastrointestinal bleeding, 5.3% menorrhagia, 2.1% hematuria, 2.1% subconjunctival hemorrhage, 31.9% were asymptomatic). Acute ITP was seen in 24 patients (25.5%) and chronic in 70 (74.5%). Patients with chronic ITP had higher mean age at diagnosis (P=0.001). However, other predictors including gender, skin manifestation, incidental, and platelet count at diagnosis were not statistically significant. Conclusion: Majority of the cases showed complete response to the first-line treatment (steroid, IVIG, anti-D). Adult age was the only predictor factor associated with chronic ITP.

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