Desperately seeking information regarding Chronic ITP 
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 Desperately seeking information regarding Chronic ITP

I'm seeking information from anyone familiar with an auto-immune disorder
known as ITP.  My 4-year old son was diagnosed with Chronic ITP 10 months ago,
and I'd like to hear/share experiences regarding treatment, successes, failures
length-of-illness, relapses, etc.  Thanks in advance.
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Sat, 25 May 1996 07:59:48 GMT
 Desperately seeking information regarding Chronic ITP

Quote:


>Subject: Desperately seeking information regarding Chronic ITP
>Keywords: ITP, Thrombocytopenia
>Date: Mon, 6 Dec 1993 23:59:48 GMT
>I'm seeking information from anyone familiar with an auto-immune disorder
>known as ITP.  My 4-year old son was diagnosed with Chronic ITP 10 months ago,
>and I'd like to hear/share experiences regarding treatment, successes, failures
>length-of-illness, relapses, etc.  Thanks in advance.
>--

I did my PhD on platelet kinetics in chronic ITP, so I'll be glad to help
where I can.  Chronic ITP usually occurs in {*filter*}s and is associated with a
low platelet count and a bleeding disorder (usually bleeding under the skin
which is easily seen as reddish spots or purpura and easy bruising).  The
disorder is nowadays called autoimmune thrombocytopenic purpura, but other
names such as immune thrombocytopenic purpura or idiopathic thrombocytopenic
purpura are still in use.  It also used to be known as von-Werlhof
syndrome.  Basically, the body starts to produce antibodies against its own
platelets, resulting in increased destruction of platelets and thus a lowering
in the platelet count in the {*filter*}.  Because platelets are a necessary part of
the {*filter*} clotting system, certain types of bleeding can occur, especially
capillary bleeding.  This usually only occurs if the platelet count falls very
low, say less than about 10 x 10^9/l.  The disease occurs more frequently in
women than men (about 3:1 ratio).  The immune thrombocytopenia found in
children is usually of the acute type and is elicited by certain virus
infection (rubella, measles).  If this ITP occurred shortly after a virus
disease it should clear up after a few weeks.  Nevertheless, chronic ITP does
occur in children as well, but diagnosis is not always easy.  Chronic ITP is
sometimes but not necessarily, a forerunner of other autoimmune diseases, such
as SLE(systemic lupus erythromatosus).

The treatment usually entails medication with steroids, depending on the
individual circumstances.  Steroids control the immune destruction of
platelets and the ITP can clear up after a few years, but relapses occur
quite often.  I am not sure how long the disease can last in children.  
Sometimes, if the steroid therapy is ineffective or splenic sequestration of
platelets is high, a splenectomy can be considered, but then only if the
patient is an {*filter*}.  I think conservative therapy would be very wise for a
4-year old child.  A more recent treatment is the intravenous administration
of high doses of immunoglobulins - this is only effective for a few days to
maybe a week or two, and is usually only given in crisis periods (i.e. just
before an operation and the platelet count is very low).  

There  is still some controversy about the effectiveness of splenectomy, but
the scientific literature seems to have the consensus that that at most 20% of
patients don't respond to splenectomy (platelet count remains very low).  I
don't know the full history of your son's illness, but I would guess that he
may "grow" out of it after puberty.

I hope this answers some of your questions

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Tue, 28 May 1996 23:20:16 GMT
 
 [ 2 post ] 

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