PTI chez l’enfant intérêt du dépistage des anticorps antiplaquettaires

Abstract

Immune-Thrombocytopenic Purpura or ITP is the most common benign hematological disorder in pediatrics. It is an isolated thrombocytopenia of peripheral destructive origin. It is a diagnosis of elimination retained once all other origin of thrombocytopenia removed. Our study concerned 32 cases of ITP, all seen at the pediatric pole of the University Hospital of Setif from December 2021 to May 2022. Our goal was to explore the pathology, physiology,diagnosis and management of patients with ITP in the literature’s data and to compare them to our results as well as to demonstrate the role that the MAIPA technique can have if it applied as a routine examination. The median age of our patients was 6 years with a sex ratio of 0.61. The mode of sudden appearance of symptoms is predominant, purpura was the constant symptom and preponderant to the clinical evaluation. Concerning the treatment 26 patients were placed on steroids, 17 under IVIg, 2 were splenectomized, 1 patient received Dapsone,another one received Anti-CD20 and 4 patients received Romiplostim. We found 8 complete remissions, 21 unfavorable evolutions and 3 without follow-up. After analysis of 11 sera collected from our patients by the MAIPA technique we found that patients with anti-GPIIbIIIa antibodies were resistant to corticosteroid therapy, however patients with antiGPIbIX antibodies responded better to corticosteroids than to intravenous immunoglobulins. Thus, a thorough study on the application of the MAIPA technique as a first-line examination before drug prescription is still necessary for a better management of children with ITP.