THE ROLE OF METHYLPREDNISOLONE IN CHILDREN WITH IMMUNE THROMBOCYTOPENIC PURPURA: A CASE REPORT

Immune Thrombocytopenia Purpura (ITP) is a bleeding disease often found by doctors, with an incidence of about 1 in 10,000 children, rarely found in infants < 1-year-old. Bleeding often occurs when the platelet is <20,000/uL. This study aims to show that methylprednisolone is effective in severe thrombocytopenia. A girl of 2 months and nine days, weighing 5.6 kg, came to the hospital with complaints of petechiae on the forehead, cheeks, and extremities. The patient is not feverish, pale, weak, cannot drink. No history of trauma. Purpura on the elbows and knees. Laboratory: Hb 8.1 g/dL, leukocytes 12,290/uL, platelets 1000/uL, hematocrit 22.2%, Diff Count: basophils 0%, eosinophils 3%, stems 1%, segments 17%, lymphocytes 70%, monocytes 9%. Peripheral blood features hypochromic, microcytic, lymphocytosis, platelets not found. The diagnosis is newly diagnosed ITP with anemia due to bleeding. The patient was treated at hand-carried ultrasound, given 2U platelet transfusion, 75 mL Packed Red Cells transfusion, 1-2 mg/kg body weight of methylprednisolone every 12 hours for seven days. The patient went home in stable. Methylprednisolone in the acute phase can increase the platelet count. Platelet suspension transfusion is only done if thrombocytopenia is accompanied by bleeding difficult to resolve.