A Retrospective Study on the Prognosis of Idiopathic Thrombocytopenic Purpura in Children

• Published in: The Japanese Journal of Pediatric Hematology Vol. 13; no. 5; pp. 342 - 345
• Main Authors: DEN Miwako, TAKI Masashi, ITOH Hironobu, IKEDA Kaori, YAMADA Kaneo
• Format: Journal Article
• Language: Japanese
• Published: THE JAPANESE SOCIETY OF PEDIATRIC HEMATOLOGY/ONCOLOGY 1999; 特定非営利活動法人 日本小児血液・がん学会
• Subjects: idiopathic thrombocytopenic purpura (ITP); lupus anticoagulant (LA); prognosis
• ISSN: 0913-8706; 1884-4723
• DOI: 10.11412/jjph1987.13.342

Eighty-eight patients with ITP in children, treated in our center, were divided into acute and chronic types, and their clinical findings and results of clinical laboratory tests at the onset were retrospectively compared between the acute and chronic types. Furthermore, the prognosis of chronic types was examined. No difference was found between acute and chronic types in the age of onset, sex, presence of preceding infection, initial symptoms, treatment, platelet counts, PA-IgG levels, presence of antinuclear antibody, and/or LE test. Lupus anticoagulant (LA) was significantly more frequent in the chronic type than in the acute type and was considered one factor for poor prognosis. With respect to the prognosis of chronic types, the rates of spontaneous remission at 1, 2, and 8 years were 9, 40, and 60%, respectively. Patients who had no remission 6 years or more after the onset, often had a complication of abnormal immunity such as collagen disease and antiphospholipid antibody syndrome. 当施設で治療した小児ITP88例について, 急性型と慢性型に分類し, 発症時の臨床所見, 検査成績を後方視的に比較した.さらに, 慢性型の予後についても検討した.発症年齢, 性別, 先行感染の有無, 発症時の症状, 初期治療の内容, 血小板数, PA-IgG値, 抗核抗体またはLEテストの有無については急性型, 慢性型の両群間に有意差は認められなかった.一方, lupus anticoagulant (LA) は慢性型に有意に多く認められ, 予後不良因子の一つと考えられた.慢性型の予後については, その自然寛解率は, 1, 2, 8年後の各時点でそれぞれ9, 40, 60%であった.発症後6年以上経過した患者のうち, 現時点においても寛解が得られていない症例は, 膠原病, 抗リン脂質抗体症候群などの免疫異常を有する疾患との合併例が多くみられた.