[Course of the disease in relation to the therapy in idiopathic thrombocytopenic purpura in childhood].
The case histories of 79 children with idiopathic thrombocytopenic purpura (ITP) were retrospectively analyzed. The course was acute in 53 patients, chronic in 24, and recurrent in 2. In cases of acute ITP (aITP) the duration of disease in children who had received high-dose immunoglobulin therapy was on average 3.4 days shorter than in the untreated group, while in children who were given glucocorticoid therapy it was longer. Among the cases of chronic ITP, splenectomy in 5 out of 7 patients caused the thrombocyte count to return to normal, while in the other patients the increase was at least so high that there was no reason to fear the occurrence of hemorrhage. If the course is complicated in a case of chronic ITP, surgery should be considered, especially as the alternatives (glucocorticoids, high-dose immunoglobulin, vincristine) only led to a temporary success in our patients and hence only appear indicated in certain situations (e.g., when surgery is planned).