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Childhood idiopathic thrombocytopenic purpura in the Nordic countries: Epidemiology and predictors of chronic disease
Author(s) -
Zeller Bernward,
Rajantie Jukka,
HedlundTreutiger Iris,
Tedgård Ulf,
Wesenberg Finn,
Jonsson Olafur G,
Henter Jan Inge,
Rosthøj Steen
Publication year - 2005
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2005.tb01887.x
Subject(s) - medicine , epidemiology , thrombocytopenic purpura , disease , pediatrics , chronic disease , purpura (gastropod) , immunology , intensive care medicine , platelet , ecology , biology
Aim: To describe the epidemiology of idiopathic thrombocytopenic purpura (ITP) in the Nordic countries, to define clinical subgroups and to investigate factors predicting chronic disease. Methods: A prospective registration was done from 1998 to 2000, including all children with newly diagnosed ITP aged 0–14 y and at least one platelet count <30×10 9 /l. Results: 506 children were registered and 423 followed for 6 mo. The incidence was 4.8/10 5 per year. Most children were aged 0–7 y (78%), with a predominance of boys, while patients aged 8–14 y had equal representation of the two sexes. There were seasonal variations determined by variations in postinfectious cases with sudden onset. The platelet count was <10×10 9 /l in 58%, but bleeding manifestations were mild or moderate in 97%. The insidious form (symptoms for more than 2 wk) was more frequent in older children and girls, showed little seasonal variation, had milder manifestations and ran a chronic course in more than half the cases. Intracranial haemorrhages did not occur in the first 6 mo after diagnosis. Chronic ITP developed in 25%. The strongest predictor of chronic disease was insidious onset of symptoms (OR 5.97). Conclusion: In the Nordic countries, ITP mainly affects children aged 0–7 y, with a winter bulk of postinfectious cases superimposed on a steady occurrence of non‐infectious cases. Clinically, it may be useful to distinguish between children with sudden versus insidious onset of symptoms rather than between different age groups.