Initial Management of Childhood Acute XXXX : Single-Center Experience of 32 Years.

@entity1 @entity882 @entity6668 @entity230 @entity3039 @entity479
UNASSIGNED: @entity3039 ( @entity3039 ) is an acute self-limited disease of childhood, mostly resolving within 6 months irrespective of whether therapy is given or not. Treatment options when indicated include corticosteroids, intravenous immune globulin (IVIG), and anti- @entity6668 immunoglobulin. We reviewed our 32  years' experience for first-line therapy of acute @entity3039 . Five hundred forty-one @entity1 (mean age: 5.3  years) diagnosed and treated for @entity3039 were evaluated retrospectively. Among 491 acute @entity3039 @entity1 , IVIG was used in 27%, high-dose @entity230 in 27%, low-dose @entity230 in 20%, anti-D immunoglobulin G (IgG) in 2%, and no therapy in 22%. When the initial response (platelets >50 * 10(9)/L) to first-line treatment modalities were compared, 89%, 84%, and 78% @entity1 treated by low-dose @entity230 , high-dose @entity230 , and IVIG responded to treatment, respectively (P > .05). Mean time to recovery of platelets was 16.8, 3.8, and 3.0  days in @entity1 treated with low-dose @entity230 , high-dose @entity230 , and IVIG, respectively (P < .0001). @entity882 recurred in 23% of low-dose @entity479 , 39% of high-dose @entity479 , and in 36% of IVIG (P < .0001) treatment groups. Of 108 @entity1 who were observed alone, 4 (3%) had a recurrence on follow-up and only 2 of these required treatment subsequently. Recurrence was significantly less in no therapy group compared with @entity1 treated with 1 of the 3 options of pharmacotherapy (P < .0001). Response rates were similar between @entity1 treated by IVIG and low- and high-dose @entity230 ; however, time to response was slower in @entity1 treated with low-dose @entity230 compared with IVIG and high-dose @entity230 .
