While ITP guidelines in the U.K. Management options include observation without specific treatment or active therapy with corticosteroids, intravenous immunoglobulin (IVIG) or with anti-D immunoglobulin (anti-D) for Rh-positive children.
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Decisions remain preference-sensitive because the benefits of any single option do not clearly outweigh potential risks. Appointments should be regularly scheduled until platelet counts have recovered, with frequency of follow-up depending on the clinical scenario and platelet count. 2.9. 3 0 obj
Whether early treatment affects the risk for life-threatening bleeding complications or for developing chronic ITP is unclear This practice point summarizes the most recent recommendations from the American Society of Hematology In 2011, the American Society of Hematology (ASH) released a clinical practice guideline on the evaluation and management of ITP Before publication of the 2011 guidelines, children hospitalized for typical, newly diagnosed ITP in the United States usually received IVIG treatment (i.e., in approximately 78% of cases) The relative rarity of severe bleeding with ITP makes it unlikely that future trials will fully establish the risks and benefits of active treatment or alleviate the decisional conflict that exists among providers and families considering treatment options. Shared decision-making can enhance patient-centred care and ensure that the families have a full understanding of the management options available.Newly diagnosed primary immune thrombocytopenia (ITP) typically occurs in healthy children and is characterized by immune-mediated destruction of otherwise normal platelets. 2018;71:e13–e115. endobj
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Older children’s personal goals relating to their participation in or return to regular activities after an episode should also be accounted for. Out of 4,937 children with ITP, the number receiving pharmacological treatment increased post-guideline (94.1% versus 92.9%). It was also reviewed by representatives of the Canadian Paediatric Thrombosis and Hemostasis Network, with our thanks.© 2020 Canadian Paediatric Society. ITP persists. All rights reserved. Other guidelines, such as regulatory guidelines, good-manufacturing-practice guidelines and pharmacovigilance guidelines, were excluded from this re-organisation exercise. Treatments do not resolve the condition faster but can temporarily raise platelet count. Options for initially managing young patients with ITP who experience bruising, petechiae or occasional mild epistaxis not interfering with daily living include observation without pharmacotherapy as a first-line option. ITP affects approximately 5 in 100,000 children per year, most commonly between age 2 to 5 years Typical ITP can be diagnosed based on classic features of the patient’s history, physical examination and laboratory investigation.
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DIOPATHIC thrombocytopenic purpura (ITP, also known as primary immune thrombocytopenic purpura) is a hematologic disorder for which appropriate diagnostic and treatment strategies are uncertain.
Protocole de prise en charge des thrombopénies immunes aiguës, nouvellement diagnostiquées, au CHU Sainte-Justine: This practice point was reviewed by the Community Paediatrics Committee and the Emergency Medicine and Hospital Paediatrics Sections of the Canadian Paediatric Society. The cause of ITP is not usually known, but the condition can be triggered by a viral infection or other immune phenomenon. x���]o�0����Ҿ�����GJ35��t���"�)C*������ӥkB������I��[�}*�\\�*�?�G����C��~-�e�پ�v�ry ��~:r�����P�E��bB�z7ɮؔf{�:Lr�r% o�OÁ8�%��,G����w��_����Sz�N�U������C�u��2��f�>�ߑ)��yKG��PM�k: 5 0 obj
Some people with ITP have other autoimmune conditions, such as rheumatoid arthritis, or infections such as hepatitis or HIV. 4 0 obj
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Hypertension. One recent study indicated poor uptake of the guidelines.