Clinical outcome and treatment pattern linked with chronic immune thrombocytopenia at a tertiary care teaching hospital

ITP is considered as ‘isolated thrombocytopenia with no clinically apparent associated conditions or other causes of thrombocytopenia' by the American Society for Haematology guidelines. So it is thus a condition that, to a large extent, is a diagnosis of exclusion. Asymptomatic patients of chronic ITP do not require treatment as per the guidelines unless they are bleeding or the platelet count in adults is <30,000/cmm. So here our aim is to retrospectively analyze our data regarding the factors responsible for initiating therapy and the type of therapy instituted based upon the affordability of patients and severity of bleed. We performed an observational study in our Institute in patients diagnosed as chronic ITP from the years Oct 2016 Sept 2019. Out of 113 patients diagnosed as ITP, 17 patients had chronic ITP. Patients with persistent and chronic ITP had a platelet count ranging between 5000/cmm to <1,00,000/cmm. Most common site of bleeding was cutaneous bleed in the form of petechial spots and ecchymosis (15 out of 17 patients). The majority of the patients had steroids as first treatment along with rituximab while second treatment was diverse. Children with asymptomatic thrombocytopenia did not receive any therapy. None of our patients underwent splenectomy. Identification of common clinical presentation and their treatment strategy in our study can helps to that patients who are at increased risk of this disease.