Mohammed Ali Jan.
Thrombocytopenia in children.
J Postgrad Med Inst Jan ;18(3):353-8.

Objectives: To find out the etiology, clinical profile and complications of thrombocytompenia in children. Material and Methods: This study was conducted at Hayat Shaheed Teaching Hospital, Peshawar from June 1995 to December 1996. Patients upto 12 years of age, presenting with mucocutaneous bleeding or thrombocytopenia on peripheral smear were included in the study. Detailed history and physical examination was followed by relevant investigations. Patients with complications and platelet count < 30 x 109/L were given steroids. Results: Acute immune thrombocytopenia (ITP) (32%), aplastic anemia (24%), Acute lymphoblastic leukemia (22%), lymphoma (4%), hemolytic uremic syndrome (4%), megakaryocytic hypoplasia (3%), drug induced thrombocytopenia (3%), hyperslenism (3%), neonatal thrombocytopenia (2%), plasmodium falciparum malaria (2%) and leshmaniasis (1%) were identified the main causes of thrombocytopenia in children. Petechiae, ecchymosis, epistaxis, gingival bleedings, haematuria, melena and bleeding per vagina were the presenting symptoms in decreasing order of occurrence. Subconjunctival hemorrhages, hemorrhagic bullae and retinal hemorrhages were the main complications. Intracranial bleeding, the most serious complication, was not seen in this study. Bleeding time, peripheral blood smear and bone marrow examination was performed in all patients. Of the 32 patients with acute ITP 24(75%) patients fulfilled the criteria for no therapy regimen and the rest of the 8(25%) patients were put on steroids. Conclusion: Acute ITP is the leading cause of thrombocytopenia in children. Use of steroid should be recommended in proper dosage where indicated.

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