Childhood ITP is generally a self-limiting syndrome. However, 5-15% of patients develop a chronic thrombocytopenia. We tried to find out factors predictive for chronic course in a series of 91 consecutive children who got their primary diagnosis of ITP at the Helsinki University Children's Hospital 1975-84. Age at onset varied between 0.4 and 16.0 (median 4.1) yrs; 42 were females. 51 patients had had an acute viral illness 2-4 weeks prior to diagnosis. 20 patients received corticosteroid treatment to their early bleedings.Platelet count reached 100×109/1 within 3 months in 89% of the patients. Eight children were thrombocytopenic still at 6 months (and also at 12 months) after diagnosis. Only one of these 8 patients with chronic ITP had had an antecedent viral infection. They were significantly older (median 10.0 yrs), and all but one were females. Their acute symptoms had been insidious. Use of steroids did not have any influence on outcome.These results suggest a different etiology and pathogenesis in patients with acute and chronic ITP of childhood.
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