J Hematol

Journal of Hematology, ISSN 1927-1212 print, 1927-1220 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Hematol and Elmer Press Inc

Journal website https://jh.elmerpub.com

Original Article

Volume 14, Number 3, June 2025, pages 133-138

Efficacy of Short-Course High-Dose Oral Prednisolone in Rapid Platelet Recovery for Pediatric Acute Immune Thrombocytopenic Purpura: A Prospective Cohort Study

Figure 1. (a) Descriptive statistics of platelet count at day 0, day 2, day 3, day 8, 1 month, and 3 months of study subjects. (b) Comparison of platelet counts (cells/mm³) between high-dose PDN and IVIG. IVIG: intravenous immunoglobulin; PDN: prednisolone.

**Table 1.** Basic Demographic and Clinical Profile of Pediatric Acute ITP Patients
	Frequency	Percentage (%)
GI: gastrointestinal; ICH: intracranial hemorrhage; ITP: immune thrombocytopenic purpura; IVIG: intravenous immunoglobulin; PDN: prednisolone.
Age (years)
1 - 5	35	57.38
6 - 12	26	42.62
Gender
Male	32	52.46
Female	29	47.54
Socioeconomic class
Upper	2	3.28
Upper middle	40	65.57
Lower middle	15	25.59
Upper lower	4	6.56
History of viral infection in past 4 weeks
No	31	50.82
Yes	30	49.18
Petechiae
No	23	37.7
Yes	38	62.3
Ecchymosis
No	7	11.48
Yes	54	88.52
Grade 3-4 bleeds (severe bleed: GI or ICH)
No	49	80.33
Yes	12	19.67
Treatment by high-dose PDN	49	80.33
Treatment by IVIG	12	19.67
Platelet transfusion
Yes	12	19.67
No	49	80.33

Table 1. Basic Demographic and Clinical Profile of Pediatric Acute ITP Patients

Frequency

Percentage (%)

GI: gastrointestinal; ICH: intracranial hemorrhage; ITP: immune thrombocytopenic purpura; IVIG: intravenous immunoglobulin; PDN: prednisolone.

Age (years)

1 - 5

57.38

6 - 12

42.62

Gender

Male

52.46

Female

47.54

Socioeconomic class

Upper

3.28

Upper middle

65.57

Lower middle

25.59

Upper lower

6.56

History of viral infection in past 4 weeks

50.82

Yes

49.18

Petechiae

37.7

Yes

62.3

Ecchymosis

11.48

Yes

88.52

Grade 3-4 bleeds (severe bleed: GI or ICH)

80.33

Yes

19.67

Treatment by high-dose PDN

80.33

Treatment by IVIG

19.67

Platelet transfusion

Yes

19.67

80.33

**Table 2.** Comparison of Time Taken to Attain Absence of Bleeding and Mean Time to Recover Between High-Dose PDN and IVIG
	High-dose PDN (n = 49)	IVIG (n = 12)	Total	P value
^aIndependent t-test. IVIG: intravenous immunoglobulin; PDN: prednisolone; SD: standard deviation.
Time taken to attain absence of bleeding (h)
Mean ± SD	38.71 ± 13.4	28 ± 9.34	35.72 ± 13.22	0.006^a
Median (25th-75th percentile)	48 (24 - 48)	24 (24 - 24)	24 (24 - 48)
Range	24 - 72	24 - 48	24 - 72
Mean time to recovery (platelet count > 30,000/mm³) (h)
Mean ± SD	60.04 ± 13.03	48 ± 0	57.55 ± 12.58	< 0.0001^a
Median (25th-75th percentile)	48 (48 - 72)	48 (48 - 48)	48 (48 - 72)
Range	48 - 90	48 - 48	48 - 90

Table 2. Comparison of Time Taken to Attain Absence of Bleeding and Mean Time to Recover Between High-Dose PDN and IVIG

High-dose PDN (n = 49)

IVIG (n = 12)

Total

P value

^aIndependent t-test. IVIG: intravenous immunoglobulin; PDN: prednisolone; SD: standard deviation.

Time taken to attain absence of bleeding (h)

Mean ± SD

38.71 ± 13.4

28 ± 9.34

35.72 ± 13.22

0.006^a

Median (25th-75th percentile)

48 (24 - 48)

24 (24 - 24)

24 (24 - 48)

Range

24 - 72

24 - 48

24 - 72

Mean time to recovery (platelet count > 30,000/mm³) (h)

Mean ± SD

60.04 ± 13.03

48 ± 0

57.55 ± 12.58

< 0.0001^a

Median (25th-75th percentile)

48 (48 - 72)

48 (48 - 48)

48 (48 - 72)

Range

48 - 90

48 - 48

48 - 90

**Table 3.** Multivariate Logistic Regression to Find Out Significant Risk Factors of Persistent ITP
Persistent ITP	Beta coefficient	Standard error	P value	Odds ratio	Odds ratio
ITP: immune thrombocytopenic purpura.
Age (years)	0.547	0.379	0.149	1.728	0.821	3.634
Platelet count (cells/mm³) at day 0	0.000	0.000	0.984	1.000	0.999	1.001
Platelet count (cells/mm³) at day 2	0.000	0.000	0.104	1.000	1.000	1.000
Platelet count (cells/mm³) at day 3	0.000	0.000	0.367	1.000	1.000	1.000
History of viral infection in past 4 weeks	-5.894	3.175	0.063	0.003	0.000	1.388

Table 3. Multivariate Logistic Regression to Find Out Significant Risk Factors of Persistent ITP

Persistent ITP

Beta coefficient

Standard error

P value

Odds ratio

Lower bound (95%)

Upper bound (95%)

ITP: immune thrombocytopenic purpura.

Age (years)

0.547

0.379

0.149

1.728

0.821

3.634

Platelet count (cells/mm³) at day 0

0.000

0.984

1.000

0.999

1.001

Platelet count (cells/mm³) at day 2

0.000

0.104

1.000

Platelet count (cells/mm³) at day 3

0.000

0.367

1.000

History of viral infection in past 4 weeks

-5.894

3.175

0.063

0.003

0.000

1.388