Poster Session I: Platelets disorders
Occult hemorrhage can occur in any internal organ in ITP patients. Four sites of occult hemorrhage deserve special attention including microscopic hematuria, fecal occult blood, retinal hemorrhage, and silent intracranial hemorrhage.
The aim of this study was to investigate for the frequency of subclinical bleeding in Egyptian children with ITP and its relation to different clinical and laboratory parameters of the disease including bleeding score and health quality of life.
This cross sectional study included 40 ITP patients recruited from the Pediatric Hematology&Oncology unit, Children Hospital, Ain Shams University. Occult blood in stools and urine analysis, fundus examination, and non-contrast brain MRI, for brain microbleed, were done
The total number of patients with occult bleeds was eleven. Two patients had occult blood in stool, five had microscopic hematuria, one had retinal bleeds and three patients had brain microbleeds. Their mean age was 10.23 ± 4.18 and their mean initial bleeding score was 2.55 ± 0.82. Nine patients with occult bleeding were chronic, one persistent and one acute ITP patients. There was no significant differences between patients with occult bleeding and those without as regards the initial bleeding score, the platelet counts & hemoglobin level, as well as the mean platelet counts & mean hemoglobin level over the disease duration. Although the scoring of the effect on the parent's life, Child and parents quality of life was low in 3 out of 11 patients with occult bleeding, we did not find a significant difference between patients with occult bleeding and those without as regards the ITP health quality of life items
Our results suggest that subclinical bleeding is a potential risk in children with ITP, more commonly chronic ITP patients. We could not demonstrate a significant relation of occult bleeding to the laboratory findings, bleeding score, and the ITP health quality of life; nevertheless, the significance of the routine assessment of occult bleeding in ITP and the identification of high-risk patients require additional studies.