Management of Acute Childhood Idiopathic Thrombocytopenic Purpura according to AIEOP Consensus Guidelines: Assessment of Italian ExperienceDel Vecchio G.C.a · De Santis A.a · Giordano P.a · Amendola G.b · Baronci C.c · Del Principe D.d · Nobili B.e · Jankovic M.f · Ramenghi U.g · Russo G.h · Zecca M.i · De Mattia D.a ·
aDipartimento di Biomedicina dell’Età Evolutiva, Università di Bari, Bari, bU.O Ematologia e Oncologia Pediatrica, Ospedale ‘Umberto I’, Nocera Inferiore, cDipartimento di Onco Ematologia Pediatrica e Medicina Trasfusionale, Ospedale Pediatrico Bambino Gesù and dDipartimento di Sanità Pubblica, Clinica Pediatrica, Università Tor Vergata, Roma, eDipartimento di Pediatria, Seconda Università degli Studi di Napoli, Napoli, fClinica Pediatrica, Ospedale San Gerardo-Monza, Università di Milano-Bicocca, Milano, gDipartimento di Scienze Pediatriche e dell’Adolescenza, Università di Torino, Torino, hCentro di Riferimento di Ematologia ed Oncologia Pediatrica, Università di Catania, Catania, iDipartimento di Scienze Pediatriche, Università di Pavia, Pavia, Italia
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Article / Publication Details
Background: Consensus guidelines for diagnosis and treatment of acute childhood idiopathic thrombocytopenic purpura (ITP) were published in 2000 by the Italian Association of Pediatric Haematology and Oncology (AIEOP). The assessment of guideline implementation was the primary objective of the present study. Patients and Methods: Information on each newly diagnosed case of ITP referring to centres conforming with the guidelines was obtained by a questionnaire. Results: Data concerning 609 new cases of acute childhood ITP were collected including 346 (56.8%) asymptomatic-paucisymptomatic forms (type A), 262 (43%) intermediate clinical forms (type B), and 1 (0.2%) severe form (type C). At diagnosis, 82% of cases were hospitalized. Age, platelet count and duration of hospitalization were significantly different in type A and type B cases. Of the total number of cases, 25% were kept under observation, 38.6% received intravenous immunoglobulins, 23.9% oral or parenteral steroids, and 12.7% other treatments. The initial treatment turned out to be appropriate for 428 cases (72.2%), of uncertain appropriateness in 71 (11.9%), and inappropriate in 95 cases (15.9%). The total level of implementation was 84.1%. Conclusions: A high rate of guideline implementation was observed during the study period. The guidelines should be reviewed taking into account more recent evidence.
© 2008 S. Karger AG, Basel
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