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2018, Number 2

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Rev Hematol Mex 2018; 19 (2)

Primary immune thrombocytopenia in children

Taboada-Mascarin BI

Language: Spanish
References: 10
Page: 95-100
PDF size: 248.12 Kb.


ABSTRACT

Primary immune thrombocytopenia (IPT) is an acquired autoimmune pathology of variable presentation; caused by destruction of platelets mediated by autoantibodies directed against antigens of the platelet membrane but also related to production deficiency. Based on the new guidelines, according to the time of evolution as follows: recent diagnosis in 3 months or less of evolution, persistent over 3 months and less than 1 year and chronic over 12 months after diagnosis. We propose to perform bone marrow aspiration in all pediatric patients with a hemorrhagic syndrome associated with thrombocytopenia in the absence of an active infectious process associated or not with other factors such as medication and/or vaccination. The first line treatment is based on the use of corticosteroids and intravenous immunoglobulin (IV). The second line includes: vincristine, cyclosporine A, danazol, azathioprine, rituximab and eltrombopag, depending on the clinical characteristics. In the third line in pediatrics, splenectomy is considered. Individualized treatment strategies are proposed. All of the above makes the difference in considering splenectomy, or offer other lines of treatment including bone marrow transplantation and non-hematological treatment in clinical manifestations associated with syndromes.


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