Toggle Main Menu Toggle Search

Open Access padlockePrints

Clinically significant acute thrombocytopenic purpura in adults: The Northern Region experience

Lookup NU author(s): Dr Annette Neylon, Professor Stephen Proctor, Dr Peter Saunders, Dr Penelope Taylor

Downloads

Full text for this publication is not currently held within this repository. Alternative links are provided below where available.


Abstract

Since 1 January 1993, Consultant Haematologists in the Northern Health Region of England (pop. 3.08 million) have registered all new cases of ITP centrally. Patients aged <16 years, those with a platelet count > 50 x 109/1 and pregnant women were excluded. Confirmation of the diagnosis by bone marrow examination was mandatory for inclusion in the study. 248 consecutive unselected patients, 150 f, 98 m (ratio 1.53 : 1) were assessed, median age 57 years (range 16-91), median platelet count 10 (range 0 - 49) with the majority having Hb and WCC in the normal range (Hb median 13.1, range 1.3 to 19.1 ; WCC median 7.4, range 2.9 to 52). Of 248 patients, 16% were asymptomatic, 68.7% had purpura, and 15.3% had a bleeding diathesis. There was no difference between genders in mode of presentation. 10% of the patients had concomitant malignancy (with 4% haematopoietic), 2.5% had inflammatory bowel disease and 10% were related to drugs, over half being attributed to quinine (median age in patients due to quinine was 69 (range 45 -82)). The median age of patients documented to have preceding viral symptoms was 23 years (range 16-61) and in total there was a documented viral illness in 12% of the overall population. Treatment was initially steroids, followed by IgG with splenectomy as 3rd line, though physicians could treat as they wished. Presenting platelet count < 5 (32% of total) -84% received steroid alone of whom 65% required no further treatment. 14% proceeded to splenectomy Presenting platelet count 6-10 (20%) -78% had steroid alone, with 42% requiring no further treatment. 16% proceeded to splenectomy. Presenting count 11 -20 (20%) -84% received steroids and 56% required no further treatment. 16% proceeded to splenectomy. Presenting count > 20 (28%) -50% received treatment, only 4% required splenectomy. There was only 1 death in the acute phase (from GI haemorrhage) and the majority of patients required no treatment other than steroids. Only 11% proceeded to splenectomy. Population based data demonstrates profound differences in ITP in adults from published studies from single institutions.


Publication metadata

Author(s): Neylon A, Howard M, Proctor SJ, Saunders PWG, Taylor PRA

Publication type: Article

Publication status: Published

Journal: Blood

Year: 2000

Volume: 96

Issue: 11

Pages: 68B-68B

ISSN (print): 0006-4971

ISSN (electronic): 1528-0020

Notes: Conference: Annual meeting of the American Society of Hematologists. Abstract 3968


Share