All issues > Volume 47(4); 2004

Original Article

Korean J Pediatr. 2004;47(4):412-416. Published online April 15, 2004.

Study on the Correlation between Clinical Classification according to Hemorrhagic Symptoms and Platelet Counts in Childhood Idiopathic Thrombocytopenic Purpura

Ho Il HI Bang¹, Sae Ron SR Shin², Du Young DY Choi¹

¹Department of Pediatrics, Wonkwang University School of Medicine, Iksan, Korea
²Department of Family Medicine, Jeon Ju Hospital, Jeon Ju, Korea

Correspondence Du Young DY Choi ,Email: cdy8118@wonkwang.ac.kr

Abstract

Purpose
: Idiopathic thrombocytopenic purpura(ITP) is a relatively common hematologic disease in children. The optimal strategy for treating ITP during childhood is a matter of controversy. In general, platelet count has been the primary, if not the sole measure, on which treatment decisions have been made and outcomes determined. In this study, we tried to find out the correlation between clinical classification of Bolton-Maggs and platelet counts in childhood ITP on initial diagnosis
Methods
: Seventy three patients with acute ITP in the Department of Pediatrics, Wonkwang University Hospital from June 1995 to December 2002, were enrolled. We retrospectively analyzed charts and classified our patients into four groups(no, mild, moderate, severe symptoms) according to Bolton-Maggs criteria.
Results
: The ratio of female to male is 0.82. The peak age incidence was two to five years(41%). It was prevalent in the spring in 23 cases(31%) and winter season in 23 cases(31%). Most common clinical symptoms at presentation were petechiae and purpura in 55 cases(75.1%). According to Bolton-Maggs criteria, our patients, classified into no symptoms, mild symptoms, moderate symptoms and severe symptoms were 9 cases(12%), 22 cases(29%), 23 cases(30%) and 19 cases(25%), respectively. Among the 47 patients with platelet counts below 20,000/mm3, those with no symptoms, mild symptoms, moderate symptoms and severe symptoms were : 1 cases(0.02%), 13 cases(27%), 17 cases (36%) and 16 cases(34%) respectively. We found that this classification was highly correlated with the platelet counts on initial diagnosis(P=0.005).
Conclusion
: There was a significant correlation between clinical classification of Bolton-Maggs and platelet counts. Therefore, this classification may be helpful in choosing the appropriate treatment options and evaluating the overall outcomes in childhood ITP.

Keywords :Idiopathic thrombocytopenic purpura, Clinical classification