• Clinical and Experimental Pediatrics
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• v.49 no.8
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• pp.830-832
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• 2006

Immune thrombocytopenic purpura(ITP) is an autoimmune disease characterized by increased peripheral platelet destruction due to antibody to platelet, which results in thrombocytopenia and cutaneous or mucosal bleeding. Bleeding generally occurs when platelet counts fall to less than $20,000/{\mu}L$. Children affected with ITP are usually healthy prior to the onset of the disease and typically present suddenly after a viral infection or insidiously with progressive petechiae, bruising, or purpura. In most cases the disease is self-limited; approximately 80% of children recover by 6 months after diagnosis, with or without treatment. Children with thrombocytopenia persisting for more than 6 months are defined as having chronic ITP. Clinical manifestations, diagnosis, laboratory findings, differential diagnosis and various treatment modalities are reviewed.

• Clinical and Experimental Pediatrics
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• v.58 no.5
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• pp.178-182
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• 2015

Purpose: The purpose of this study was to determine the frequency of $CD4^+CD25^+FoxP3^+$ regulatory T cells (Treg) in the peripheral blood of patients with childhood chronic immune thrombocytopenic purpura (ITP) exhibiting thrombocytopenia and spontaneous remission. The findings of this study indicate the possibility of predicting spontaneous recovery and pathogenesis of childhood chronic ITP. Methods: Eleven children with chronic ITP (seven thrombocytopenic and four spontaneous remission cases; mean age, 8.8 years; range, 1.7-14.9 years) were enrolled in this study. Five healthy children and eight healthy adults were included as controls. The frequency of Treg was evaluated by flow cytometry in the peripheral blood. Results: In this study, four patients (36%) achieved spontaneous remission within 2.8 years (mean year; range, 1.0-4.4 years). The frequency of Treg was significantly lower in patients with persisting thrombocytopenia ($0.13%{\pm}0.09%$, P<0.05), than that in the patients with spontaneous remission ($0.30%{\pm}0.02%$), healthy adults controls ($0.55%{\pm}0.44%$), and healthy children controls ($0.46%{\pm}0.26%$). A significantly positive correlation was found between the frequency of Treg and the platelet count in children. Conclusion: These data suggest that a lower frequency of Treg contributes to the breakdown of self-tolerance, and may form the basis for future development of specific immunomodulatory therapies. Furthermore, Treg frequency has prognostic implication toward the natural course and long-term outcomes of childhood chronic ITP.

• Journal of Yeungnam Medical Science
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• v.40 no.3
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• pp.241-246
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• 2023

Immune thrombocytopenia (ITP) is a disease in which thrombocytopenia occurs because of immune-mediated platelet destruction and decreased platelet production. Although many pediatric patients with ITP experience spontaneous remission or reach remission within 12 months of first-line therapy, approximately 20% progress to chronic ITP. Patients who do not respond to first-line treatment or experience frequent relapses are of great concern to physicians. This review summarizes recent treatments for second-line treatment of pediatric chronic ITP.

• The Journal of Korean Medicine
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• v.34 no.2
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• pp.59-65
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• 2013

Objectives: This case report was conducted to introduce the effectiveness of herbal decoction on patients with chronic immune thrombocytopenic purpura (ITP). Methods: We closely observed two patients who were admitted to the Department of Internal Medicine 1 of Kyung-Hee Korean Medical Hospital due to ITP. We gave a herbal decoction to these patients and then analyzed the changes in their general conditions as well as blood test results. Results and Conclusions: The treatment with herbal decoctions was helpful for ITP patients.

• Journal of Yeungnam Medical Science
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• v.38 no.2
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• pp.165-168
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• 2021

We report the case of a 16-month-old patient with chronic immune thrombocytopenia (ITP) patient who experienced delayed treatment-free response (TFR) after romiplostim treatment. He received intravenous immunoglobulin every month to maintain a platelet count above 20,000/µL for 2 years. Thereafter, he received rituximab and cyclosporine as second-line therapy, with no response, followed by romiplostim. After 4 weeks of treatment, the platelet count was maintained above 50,000/µL. Following 7 months of treatment, he discontinued romiplostim, and the platelet count decreased. His platelet counts remained above 50,000/µL, without any bleeding symptoms, 2 years after romiplostim discontinuation. This is the first report of TFR after romiplostim treatment in pediatric chronic ITP.