Secondary immune thrombocytopenia in children: Characteristics and outcome of a large cohort from two Spanish centres.
AIM
To evaluate the incidence and outcome of secondary immune thrombocytopenia (ITP) in a large cohort of paediatric Spanish patients.


METHODS
A retrospective observational study was conducted in two paediatric University hospitals in Spain between 2009 and 2019, which included children from 4 months to 18 years old diagnosed with ITP. Data were recorded from clinical charts: gender, age at diagnosis, coexisting condition and associated characteristics, outcome and treatment.


RESULTS
Secondary ITP was diagnosed in 87 out of 442 patients (19.6%). Post-immunisation ITP was seen in younger children. The onset of secondary ITP to autoimmune diseases (AD) and immunodeficiencies (ID) was at an older age and had more tendency to be insidious, and platelet level was higher than primary ITP. Mean time from ITP onset to AD diseases or ID diagnosis was 1.2 and 2.6 years, respectively. Whereas the cumulative incidence of remission was significantly higher in post-immunisation and post-viral infection (compared with primary ITP patients), it was worse in AD and ID patients.


CONCLUSIONS
Identification of secondary ITP is important as it predicts outcome. Most of them are diagnosed at ITP onset, but AD diseases and ID should be ruled out periodically as they are usually identified later.
['Berrueco|Rubén|R|0000-0002-1068-7489', 'Sebastián|Elena|E|', 'Solsona|María|M|', 'González de Pablo|Jesús|J|', 'Ruiz-Llobet|Anna|A|', 'Mesegué|Montse|M|', 'Gálvez|Eva|E|', 'Sevilla|Julián|J|']
D000368:Aged D002648:Child D006801:Humans D015994:Incidence D016553:Purpura, Thrombocytopenic, Idiopathic D012189:Retrospective Studies D013030:Spain D013921:Thrombocytopenia
immune thrombocytopenia children paediatric autoimmune diseases immunodeficiency vaccines