Objective:

To identify clinically relevant factors associated with disease course, diagnostic revision, and initial management in children newly diagnosed with immune thrombocytopenia (ITP), emphasizing the importance of identifying risk factors for chronicity.

Key Findings:

• 271 patients included; 240 diagnosed with ITP, 31 with alternative diagnoses. Median age was 4 years.
• Chronic ITP associated with older age (OR 1.08), absence of preceding infection/vaccination (OR 0.45), and higher platelet count at diagnosis (OR 1.03).
• Patients with alternative causes of thrombocytopenia were older and had lower bleeding grades.
• Upfront pharmacological therapy was associated with younger age, higher bleeding grades, and lower platelet counts compared to observation.

Interpretation:

Readily available data may help identify children at risk for chronic disease and those with alternative causes of thrombocytopenia. Initial treatment decisions were influenced by clinical presentation, highlighting the need for tailored approaches.

Limitations:

• Single-center study may limit generalizability.
• Retrospective design may introduce bias in data collection and interpretation, including selection bias.

Conclusion:

The study highlights the importance of identifying risk factors for chronic ITP and alternative diagnoses in pediatric patients, which can inform clinical management.