A Study of Epidemiology and Therapeutic Response of Patients with Immune Thrombocytopenic Purpura

Immune thrombocytopenic purpura (ITP) is a disease characterized by decrease of the peripheral blood platelet count. The disease presents in acute and chronic forms. Because of the importance and high prevalence of ITP, it was decided to study the therapeutic response of patients with ITP.
Material and A cross-sectional study was conducted at Ghaem hospital, Mashhad, Iran. The diagnosis was based on clinical symptoms and laboratory findings. All of the patients were treated by ITP conventional treatment. Then, the therapeutic response was evaluated.
The population of this study included 288 ITP patients, 159 were diagnosed with acute ITP (132 pediatric: 6 months to12 years and 27 adult: 13-58 years old) and 69 with chronic ITP (43 female and 26 male). Among pediatric patients, 75 were girls and 57 boys. The mean age in acute ITP was 11 years and in chronic ITP was 28 years old. According to T-test, significant relation was found between age in type of ITP (P=0.000). In men, %77 suffered from acute ITP and %23 from chronic form while in female acute ITP was %62 and chronic ITP was %38. According to Fisher-Test, no significant relation was found between sex in type of ITP (P=0.842). After the conventional treatment with prednisolone, 19 cases were considered as corticosteroid-refractory ITP. The second step in treatment of corticosteroid-refractory ITP was splenectomy. Responsiveness to splenectomy was 84% and 16% were unresponsive to splenectomy and immunosuppressive therapy, and they expired with signs of bleeding.
The acute type of ITP was common among patients at age range of 3 to 4 years. The chronic ITP was more common among adults and also more frequent in female. Splenectomy in patients with chronic ITP was associated with a good response in most cases, but the response to immunosuppressive agents in this group was poor.