[Novelties in the treatment of pediatric immune thrombocytopenia - 2017]

Orv Hetil. 2017 Dec;158(48):1891-1896. doi: 10.1556/650.2017.30934.
[Article in Hungarian]

Abstract

Immune thrombocitopenia in children is a very variable disease. International recommendations give therapeutic possibilities without strong protocols. In 2011, a therapeutic algorithm was published based on Hungarian practice. Recently, new innovative drugs have been available even in Hungary, so there is a need for modification of the therapeutic protocols. In this summary we give an overview about the current up-to-date management. In infancy and in childhood, high-dose immunglobulin treatment is recommended henceforward. In older children an alternative can be steroid therapy (pulses or long-term low-dose treatment). In resistant cases, a new thrombopoetin receptor stimulant, eltrombopag can be administered. This drug is registered in Hungary, and can very effectively influence the prognosis. Splenectomy is very rare nowadays in children. Immune thrombocytopenia is an unpredictable disease. Cure rate is about 70-80% of the cases, but management of the patients needs special care and specialist. Orv Hetil. 2017; 158(48): 1891-1896.

Keywords: bleeding; gyermekkori ITP; immunglobulin; pediatric ITP; terápiás ajánlás; therapeutic recommendation; thrombopoetin receptor stimulant; trombopoetinreceptor; vérzés.

MeSH terms

  • Adolescent
  • Benzoates / therapeutic use*
  • Child
  • Child, Preschool
  • Drug Resistance
  • Humans
  • Hydrazines / therapeutic use*
  • Immunoglobulins, Intravenous / therapeutic use*
  • Infant
  • Infant, Newborn
  • Medication Therapy Management*
  • Pediatrics
  • Prognosis
  • Purpura, Thrombocytopenic, Idiopathic / drug therapy*
  • Purpura, Thrombocytopenic, Idiopathic / surgery
  • Pyrazoles / therapeutic use*
  • Splenectomy
  • Steroids / therapeutic use*

Substances

  • Benzoates
  • Hydrazines
  • Immunoglobulins, Intravenous
  • Pyrazoles
  • Steroids
  • eltrombopag