Abstract
Abstract 4453
Immune thrombocytopenia (ITP) is an uncommon disorder of childhood. Most children recover quickly regardless of intervention, but severe bleeding develops in approximately 3%. Intracranial haemorrhage (ICH) is by far the most feared complication, occurring in 0.1-0.5%. Pharmacotherapy is available to transiently increase platelet counts, but introduction of British clinical guidelines in 1992 has resulted in a sharp decline in the number of children receiving such treatment.
The aim of this survey is to establish the current UK incidence of intracranial and other life-threatening haemorrhages in ITP, and whether or not children developing such complications have other risk factors for bleeding.
UK paediatricians were mailed a questionnaire asking to report the number of cases of ITP per year, and any cases of intracranial haemorrhages (ICH) in the previous ten years or other life-threatening haemorrhages in the past five years. Consultants reporting patients were asked to complete a form requesting detailed information on the child and the circumstances surrounding their bleed.
844 annual cases of ITP were reported from 145 centres; 672 of these were acute presentations and 240 were chronic. 24 cases of ICH and 19 cases of life-threatening bleed were identified, giving an annual incidence of 0.3% and 0.5% respectively. Gastrointestinal haemorrhage was the most commonly reported life-threatening bleed, and in six cases, ICH and life-threatening bleeds occurred in the same child.
The incidence of ICH in ITP may be higher than previously reported in the UK; the reason behind this increase remains unknown and support the need for larger international collaborative studies.
No relevant conflicts of interest to declare.
Author notes
Asterisk with author names denotes non-ASH members.
