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

↓  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.
Figure 1.

Tables

↓  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 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 0.006a
  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 < 0.0001a
  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
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 0.000 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