الفهرس 
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Abstract
Immune thrombocytopenic purpura (ITP) is an acquired autoimmune disorder and the most common cause of isolated thrombocytopenia in children. It is diagnosed clinically, based upon onset of thrombocytopenia with platelet count below 100 x 109/L in peripheral blood, in the absence of other hematologic abnormalities, or other causes of low platelets. ITP is caused by the production of anti-platelet antibodies. These autoantibodies opsonize platelets for splenic clearance, resulting in low levels of circulating platelets.
Patients diagnosed with chronic ITP will conduct splenectomy if steroids and other immunosuppressive therapy fail to control mucous membrane bleeds and /or accomplish a hemostatic platelet count and provided patient is ≥ 5 years of age and parents agree to such a procedure with all its pros and cons.
The response to splenectomy cannot be predicted using readily available clinical criteria (eg previous response to steroids or intravenous immunoglobulin), Statistical comparison between ITP patients revealed that there was no statistically significant difference between the three groups of ITP as regards their gender, presenting symptoms, clinical or laboratory data except for platelet count was significantly different among variable types of ITP patients . Patients were further subdivided into 3 groups: acute pediatric ITP and chronic pediatric ITP.and persistent pediatric ITP .There was highly statistically significant difference between these groups regarding getting splenectomy as atreatment of ITP.
The current cohort study aimed at evaluating splenectomy operation as a treatment of chronic ITP .
Splenectomy offers the greatest opportunity for cure, and societal costs appear favorable .
Delaying the decision for 12 months or more appears to lessen the need for surgery in a substantial proportion of patients. If this approach is adopted more widely, it may affect subsequent analyses because restricting splenectomy to third-line “salvage” therapy will probably reduce not only the need but also the response rate.