Introduction: Immune thrombocytopenia (ITP) is a common cause of bleeding and often a cause of concern in children. This study was conducted to describe the clinical profile of children with newly diagnosed ITP and to identify the risk factors for development of persistent ITP.

Materials and Methods: Hospital based descriptive longitudinal study conducted from January 2015 to June 2016 among children 12yrs and below admitted with a clinical diagnosis of newly diagnosed ITP. Details of history, clinical examination, investigations and treatment were noted. They were followed up for 6 months to monitor for development of Persistent ITP. Data was analyzed using SPSS software.

Results: Among the 90 children22 (24%) turned out to be persistent ITP. Most of the children were < 5 years old. The male female ratio was 1:1.2. Majority of children had grade 1 bleed. All the children had cutaneous bleeds; other bleeding manifestations were oral mucosal bleed, epistaxis, gastrointestinal bleed, subconjunctival hemorrhage and hematuria. Profound thrombocytopenia was found in about one third of cases. Bone marrow examination findings were consistent with ITP. Majority of the children were conservatively managed. None of them developed major complications like intracranial bleed. The risk factors for development of persistent ITP were identified as splenomegaly, profound thrombocytopenia and grade 2 bleed.

Conclusions: Most of the children in this study were < 5 years old.  24% of children turned to be persistent ITP. Bone marrow examination findings were normal. The risk factors for development of persistent ITP were identified as splenomegaly, profound thrombocytopenia and grade 2 bleed.

Keywords: Immune thrombocytopenia, Persistent ITP, Clinical predictors.

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Mohandas Nair Karippoth

Additional Professor Department of Pediatrics,

Government Medical College Kozhikode, Kozhikode, Kerala, India 673008

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