THROMBOCYTOPENIC IDIOPATHIC PURPURA: PREDICTIVE FACTORS FOR CHRONIC DISEASE

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Vol. 87 No. 1 (2009): Issue Jan 2009

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Sonia Mazigh Mrad
Service de Médecine Infantile C à Hôpital d'Enfants de Tunis -Jebbari Bab Saadoun- Tunis
Monia Ouederni
Service de Médecine Infantile C à Hôpital d'Enfants de Tunis -Jebbari Bab Saadoun- Tunis
Olfa Bouyahia
Hôpital d'enfants. Bab Saadoun - Tunis - Tunisie
Lamia Gharsallah
Service de Médecine Infantile C à Hôpital d'Enfants de Tunis -Jebbari Bab Saadoun- Tunis
Samir Boukthir
Hôpital d'enfants. Bab Saadoun - Tunis - Tunisie
Azza Samoud Gharbi
Service de Médecine Infantile C à Hôpital d'Enfants de Tunis -Jebbari Bab Saadoun- Tunis

Abstract

The aim of this study is to determine factors predicting development of chronic thrombocytopenic idiopathic purpura.
Methods : It was a retrospective study, regarding the cases of PTI diagnosed in “service de medicine infantile C Hôpital d’Enfants de Tunis” during 11 years. Acomparison was done between two groups: the first including acute PTI and the second including chronic and recurrent PTI. Factors predicting development of chronic disease were searched by the Fisher test which was significant when p<0,05.
Results: 33 cases of PTI were diagnosed. The ratio sex was 1.06. The mean age was five years and a half. The disease onset was insidious in three cases; all of them have had a chronic course. An haemorrhagic personnel background was present in three cases. Counselling cause was always petechies and ecchymoses. The mean platelets rate was 14555,5/mm3. Therapeutics abstinence was carried out in five cases. 20 infants received an initial corticotherapy. The
immunoglobulins were prescribed in nine cases, witch six associated to Corticotherapy. Three modes of outcome were discerned: acute PTI (n=23), recurrent PTI (n=4) and chronic PTI (n=6). Factors predicting development of chronic disease were: haemorrhagic personnel background, an insidious disease onset and the failure of an initial therapeutic abstinence.
Conclusion: Acute PTI is the most common. The disease had a chronic or recurrent outcome in 1/3 of cases. The search after factors predicting chronic disease allows an early prognosis. Thus, a best management of the disease can be achieved.

Keywords:

thrombocytopenic idiopathic purpura, chronic

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