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Many options available for pediatric ITP management
Recently published guidelines that recommend a more conservative approach may streamline management of those patients who have been recently diagnosed with immune thrombocytopenia, according to study results published online.
Sarah H. O’Brien, MD, MSc, of the Center for Innovation in Pediatric Practice, the Research Institute at Nationwide Children’s Hospital, and colleagues reported data on 2,314 patients aged 1 to 18 years from the Pediatric Health Information System who were classified as newly diagnosed immune thrombocytopenia (ITP) admissions from 2008 to 2010.
Sarah H. O'Brien
The researchers said there was “significant variation” among regions in terms of treatment approaches, but immunoglobulin G was the predominant form of treatment used.
“We were surprised that noncutaneous bleeding was only reported in 12% of hospitalized patients with ITP,” O’Brien told Infectious Diseases in Children. “Epistaxis was the most commonly reported symptom and intracranial hemorrhage occurred in 0.6%. Current international guidelines state that patients with ITP but no bleeding or cutaneous-only bleeding can be managed in the outpatient setting, with observation alone in some cases.”
The researchers also said their findings may indicate that encouraging clinicians to consult with a hematologist when the patient is not actively bleeding, rather than referring to the hospital, may be an appropriate initial first step to avoid unneccesary hospitalization and decrease healthcare costs.
“For such a strategy to work, however, hematology clinics need to have the capability of evaluating a patient with suspected ITP within the same or next business day to meet the needs of the family and referring physician,” O’Brien and colleagues wrote.
Disclosure: O’Brien reports no relevant financial disclosures.
