Clinical Outcome and Its Predictors in Children with Newly Diagnosed Immune Thrombocytopenia: Analysis of 25 Cases

Abstract

Background: Immune thrombocytopenia (ITP) is the most common cause of isolated thrombocytopenia in children, characterized by immune-mediated platelet destruction. The clinical course is variable, ranging from spontaneous remission to chronic disease. Objective: To assess the clinical outcomes and predictors of chronicity in children with newly diagnosed ITP. Methods: This prospective observational study included 25 children (mean age 4.5 ± 2.9 years) with newly diagnosed ITP. Demographic data, clinical presentation, baseline platelet counts, treatment modalities, and follow-up outcomes were recorded. Patients were followed for 12 months and classified as transient (complete remission within 12 months) or persistent/chronic ITP. Statistical analysis was performed to identify predictors of chronicity. Results: Of 25 children, 15 (60%) were male and 10 (40%) female. The mean baseline platelet count was 18,000/µL. Petechiae/purpura were the most common presentation (80%), followed by mucosal bleeding (20%). Twenty-one patients (84%) received treatment (Intravenous methylprednisolone), and four (16%) were managed conservatively. At 12 months, 20 children (80%) achieved complete remission, while five (20%) developed persistent/chronic ITP. Predictors of chronicity included age > 10 years (p = 0.04), female sex (p = 0.03), and higher platelet count at presentation (>30,000/µL) (p = 0.05). Conclusion: Most children with ITP have a benign, self-limited course. Older age, female gender, and higher baseline platelet count were significant predictors of chronicity. Early recognition of these predictors may guide risk stratification and follow-up planning.