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Arch Dis Child. 2012 Jan;97(1):8-11. doi: 10.1136/adc.2010.184234. Epub 2011 Oct 28.

Changing trends in the UK management of childhood ITP.

Author information

  • 1The University of Manchester, Manchester Academic Health Science Centre, Royal Manchester Children's Hospital, Manchester M13 9WL, UK. john.grainger@cmft.nhs.uk

Abstract

OBJECTIVE:

To compare the treatment of childhood immune thrombocytopenia (ITP) with historical practice in the UK.

DESIGN:

Data collection through a national UK Childhood ITP registry (http://www.uk-itp.org) started in January 2007.

SETTINGS:

UK hospitals.

PARTICIPANTS:

Children admitted with a new diagnosis of acute ITP and their treating physicians.

MAIN OUTCOME MEASURES:

Bleeding severity, platelet count, disease management and outcome from the time of presentation to 6 months.

RESULTS:

Data from 225 children were analysed. 54% of children had clinically mild, 42% had moderate and 4% had severe disease as defined previously. The mean platelet counts at diagnosis for these groups were 14, 8 and 6×10(9)/l respectively. Children with mild disease had fewer bleeding sites (1.9), compared with moderate (2.5) or severe disease (3.6). There was one intracranial haemorrhage reported. At 6 months' follow-up, 32% had a persistent platelet count <150×10(9)/l, but only 4.8% had a count <20. The proportion of UK children receiving platelet-raising treatment was noted to decrease from 61% in 1995 to 38% in 2000. The current UK 2009 registry data show a continued decrease in treatment to 16% of all the children. In contrast, historical international data report 69% of children receiving interventional therapy.

CONCLUSION:

The current UK practice has shown a continued reduction in the number of children receiving treatment in comparison with historical data and international practice.

PMID:
22039183
[PubMed - indexed for MEDLINE]
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