Clinical profile of thrombocytopenia in pediatric patients

Authors

  • Anuya V. Chauhan Department of Pediatrics, B. J. Medical College, Ahmedabad, Gujarat, India
  • Disha A. Mehta Department of Pediatrics, B. J. Medical College, Ahmedabad, Gujarat, India
  • Urvi Patel Department of Pediatrics, B. J. Medical College, Ahmedabad, Gujarat, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20241679

Keywords:

Thrombocytopenia, Infectious diseases, Hematology, Platelet

Abstract

Background: Thrombocytopenia is often asymptomatic and may present as an incidental finding during routine evaluation or during laboratory investigations performed for other reasons. Most common immune mediated cause of thrombocytopenia in children is immune thrombocytopenic purpura. Early diagnosis and treatment is guided by the severity and specific cause of the disease.

Methods: This prospective study included all the admitted patients between >1 month to <12 years of age confirmed as having thrombocytopenia with platelet count <1,50,000/micro-litre by laboratory methods. Detailed history regarding various symptoms of onset and progression was recorded. Data of this study was recorded in Microsoft Excel and analyzed using statistical method.

Results: This study included 120 patients with thrombocytopenia. Incidence of thrombocytopenia among hospital admission was 4.3%. Male to female ratio was 1.6:1. 55 (45.8%) patients were more than 5 years, 26 (21.67%) patients were between 3-5 years, 28 (23.33%) patients were between 1-3years, 11 (9.17%) were infants. 112 (99.2%) patients presented with fever while 81 (67.5%) patients had vomiting. Bleeding from any site and petechiae, purpura as a presenting complaint was seen only in 7 (5.8%) and 6 (5%) respectively. 24 patients received blood products.

Conclusions: Infectious diseases were the most common cause of thrombocytopenia in children particularly moderate thrombocytopenia in present study. Thrombocytopenia is a common hematological finding in many febrile illnesses like dengue, malaria. Fever, vomiting were more significant symptoms. Symptomatic and supportive treatment in form of intravenous fluids and antipyretics were required in most of the children. Very few patients required platelet rich concentrate (PRC) for treatment.

References

Kliegman RM, Toth H, Bordini BJ, Basel D, editors. Nelson Pediatric SymptomBased Diagnosis E-Book. Elsevier Health Sciences. 2022.

Lokeshwar MR, Sachdeva A, Shah NK, Manglani MV, Agarwal BR. Textbook of pediatric hematology and hemato-oncology. Jaypee Brothers Medical Publishers. 2016.

Provan D, Stasi R, Newland AC, Blanchette VS, Bolton-Maggs P, Bussel JB, et al. International consensus report on the investigation and management of primary immune thrombocytopenia. Blood. 2010;115(2):168-86.

Medeiros D, Buchanan GR. Current controversies in the management of idiopathic thrombocytopenic purpura during childhood. Pediatr Clin North Am. 1996;43(3):757-72.

Rodeghiero F, Stasi R, Gernsheimer T, Michel M, Provan D, Arnold DM, et al. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group. Blood. 2009;113(11):2386-93.

Lanzkowsky P. Manual of pediatric hematology and oncology. Elsevier. 2005.

Parthasarathy A, Menon P, Nair M. IAP Textbook of pediatrics. Jaypee Brothers. 2019.

Yokomizo K, Tomozane M, Sano C, Ohta R. Clinical Presentation and Mortality of Severe Fever with Thrombocytopenia Syndrome in Japan: A Systematic Review of Case Reports. Int J Env Res Public Health. 2022;19(4):2271.

Schlappi C, Kulkarni V, Palabindela P, Bemrich-Stolz C, Howard T, Hilliard L, Lebensburger J. Outcomes in mild to moderate isolated thrombocytopenia. Pediatrics. 2018;142(1).

Agarwal P, Dash DK, Sinha M, Kumari M, Mohanty MD, Srikant AS. Clinical profile and laboratory findings of patients with thrombocytopenia in hospital set up: A hospital based prospective study. Sri Lanka J Child Health. 2021;50(1):94-102.

Subramanian V, Kumar S. Thrombocytopenia in children: a clinico-etiological profile in an urban tertiary care hospital. Int J Contemp Pediatr. 2019;6(1):131.

Indupriya S, Yerram S, Anupama C, Etiology, treatment and outcome of pediatric thrombocytopenia due to infection: A prospective study. IP Int J Med Paediatr Oncol. 2019;5(1):6-9.

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Published

2024-06-26

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Section

Original Research Articles