Initial Lymphocyte Count and the Development of Persistent/Chronic Immune Thrombocytopenic Purpura

Background. Acute immune thrombocytopenic purpura (ITP) is a common, benign, self-limiting disease in children. Chronic ITP is diagnosed when thorombocytopenia persists beyond 12 months. Older age is associated with increased risk for development of chronic ITP. The main objective of the current study was to examine whether total leukocyte (TLC) and absolute lymphocyte counts (ALC) at diagnosis correlate with the persistence of ITP beyond 6 months. Procedure. Two hundred and twenty four consecutive medical records for patients diagnosed with immune thrombocytopenia, between April 1993 and July 2007, were reviewed and 188 patients were eligible for analysis. Case records were examined to ascertain the following information: age, gender, ethnicity, date of presentation, presenting CBC with differential count, treatment given and the outcome. Results. The male to female ratio was almost 1:1; 24% (45/188) of patients had persistent ITP beyond 6 months. We determined that age >8.5 year, TLC < 6,250/mu l and ALC < 3,050/mu l was associated with a significant risk for development of persistent ITP beyond 6 months. Conclusions. TLC and ALC at diagnosis are predictive variables for the development of persistent/chronic ITP. Further studies are recommended to confirm the current finding and to assess the underlying pathophysiology with the course of the ITP. Pediatr Blood Cancer 2010;55:508-511. (C) 2010 Wiley-Liss, Inc.