Clinical audit on the management of acquired platelet disorders in Assiut University children hospital

Introduction Platelet disorders lead to defects in primary hemostasis and produce signs and symptoms different from coagulation factor deficiencies (disorders of secondary hemostasis). Primary hemostatic disorders are characterized by prolonged bleeding time and the characteristic physical examination in the form of mucocutaneous bleeding. Initial laboratory evaluations for patients with acquired platelet disorders include complete blood count and peripheral blood smear. Treatment of patients with suspected acquired platelet disorder is generally specific to the underlying disorder. Patients and methods Data of children older than 1 month of age admitted with bleeding tendency caused by acquired platelet disorders during 1 year were collected and analyzed, and clinical management was compared with the standard management guidelines according to the American Society of Hematology 2011. Results In all patients, complete blood count was performed, whereas peripheral blood smear was performed only for 46 (60.5%) cases. Bone marrow examination was performed in 30 (39.5%) cases and it was indicated in 23 (77%) of these cases, whereas in seven (23%) cases it was done for purpose of research with guardian consent. Medical treatment (in the form of intravenous immunoglobulin and/or corticosteroids) was provided to seven (9%) cases in whom treatment was not indicated. Intravenous immunoglobulin was administered to 22 (29%) cases, and there was a delay in its administration to 10 (45%) of these cases because of unavailability. Corticosteroids were administered to 26 (34%) cases; eight (31%) of these cases received it for a longer time than indicated. Anti‑D immunoglobulin was not administered to any patient.