Role of Splenectomy in Childhood Immune Thrombocytopenic Purpura

Lee, Min Young; Park, Eun Ah; Park, Ji Kyoung; Lee, Soon Yong

Abstract

PURPOSE
Immune thrombocytopenic purpura (ITP) is an acquired autoimmune disease characterized by circulating platelet destruction. The course of most cases with childhood ITP is acute and self-limited but a few patient has a refractory or chronic course requiring splenectomy. In the Korean literatures, there were several studies related to splenectomy for patiens with ITP, but those were insufficient to prove the effect of the therapy. So the authors tried to evaluate the effect of splenectomy in the childhood ITP.
METHODS
We retrospectively analyzed the data on 18 patents that underwent splenectomy among 344 childhood patients diagnosed with ITP from 1996 to 2010 at Busan Paik hospital.
RESULTS
The median age at splenectomy was 11 years (6~19 years). The median time interval between diagnosis and splenectomy was 3 years 4 months (1 months~14 years). Of all 18 cases, 4 cases were undergone on laparoscopic splenectomy. The postsplenectomy platelet count (postop. 1 day 284x10(3)/microliter; postop. 1 month 340x10(3)/microliter; postop. 3 months 334x10(3)/microliter; postop. 6 months 305x10(3)/microliter; postop. 12 months 327x10(3)/microliter) was significantly higher than presplenectomy platelet count (11.7x10(3)/microliter).
CONCLUSION
We concluded that splenectomy was the safe and effective procedure in the refractory or chronic ITP in childhood. Further studies for long-term outcome of splenectomy in ITP are required.