Primary and secondary Immune thrombocytopenia in Moroccan children

Immunological Thrombocytopenic Purpura or ITP is the most common benign blood disease in pediatrics. The aim of this work is to analyze the epidemiological, clinical, paraclinical and etiological profile of Primary and secondary immune thrombocytopenia. It is a retrospective study over a period of four years from September 2017 to September 2021, collecting all cases of immunological thrombocytopenic purpura hospitalized in hematology pediatric unit at the Abderrahim Harouchi Children’s Hospital in Casablanca. 135 patients with ITP were hospitalized in this period including 76 boys (56.3%) and 59 girls (43.7%). The average age was 5.8 years (1 month -14 years). According to Buchanan bleeding score, 3.4% of the patients were grade 0, 9.6%, were grade 1 and 39.2% of the patients were grade 2, 41.5 % of the patients were grade 3, 5% in grade 4 and only 1 case was in grade 5. Etiologically, 86% of primary ITP and 14% of secondary ITP were recorded. The etiological assessment revealed 9 cases of Helicobacter pilori infection, 6 cases of immune deficiency (5 cases of WISKOTT ALDRICH and 1 case of ALPS) and4 probable cases of systemic lupus erythematosus. Patients were treated with either corticosteroids or intravenous immunoglobulin (IgIV). The trend was towards acute ITP in 85 cases (63%), persistent and chronic ITP in 50 cases (37%). For a better management of chronic and persistent ITP a complete etiological assessment is essential. This will allow to propose an etiological treatment and therefore an improvement of thrombocytopenia.