Cerebral Dysfunction in Chronic ITPwith High Risk of Serious Bleeding Excluding Intracranial Hemorrhage.

Study Overview
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Brief Summary
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Intracranial hemorrhage despite being rare, several chronic ITP patients experience moderate to severe behavioral problems including learning difficulties, memory affection .These changes could be due to the presence of minute capillary dysfunction

Detailed Description
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First identify the presence of cognitive, behavioral and/or minimal neurological deficit in patients with chronic ITP and correlate these changes with radiological evidence of minimal CNS bleeding. Second investigate the correlation between these behavioral and/or minimal neurological deficits and duration, site and severity of bleeding (a total of 200 patient of persistently low platelet count < 20x 10 9 for at least more than one month duration). The aim is to assess the behavioral changes in chronic ITP patients, and to assess the possible relation of such changes to duration and recurrence of very low platelet count as well as pattern of bleeding excluding frank intracranial hemorrhage.

Official Title
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Cerebral Dysfunction in Chronic ITP With High Risk of Serious Bleeding Excluding Intracranial Hemorrhage.

Conditions
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Chronic Thrombocytopenia

Intervention / Treatment
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* Other: IQ assessment and visual- motor assessment
* Other: EEG,brain imaging


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Chronic ITP patients with persistent platelet count < 20 x 109/L for a period more than one month. Chronic ITP with more than one attack of wet purpura and OR internal bleeding. Exclusion Criteria: Patients' with platelet count persistently more than 40 x 109/L. Past history of intracranial hemorrhage. Past history of known neurological or psychological deficit diagnosed before onset of ITP diagnosis

Ages Eligible for Study
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Minimum Age: 4 Years
Maximum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| chronic itp and cerebral dysfunction<br>patients with chronic itp and had behavioral and or cognitive dysfunction | Other: IQ assessment and visual- motor assessment<br>* Psychological examination and evaluation for both groups to diagnose those with behavioral and /or cognitive dysfunction.<br>* Other names: Wisconsin Card Sorting test;Other: EEG,brain imaging<br>* For patients with cognitive or behavioral deficit, MRI brain and quantitative EEG will be done to identify any CNS abnormality.<br>* Other names: MRI brain;|
| chronic itp only<br>chronic ITP patients without cerebral dysfunction | Other: IQ assessment and visual- motor assessment<br>* Psychological examination and evaluation for both groups to diagnose those with behavioral and /or cognitive dysfunction.<br>* Other names: Wisconsin Card Sorting test;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| cognitive, behavioral and/or minimal neurological deficit in patients with chronic ITP | cognitive, behavioral and/or minimal neurological deficit in patients with chronic ITP and correlate these changes with radiological evidence of minimal CNS bleeding. | 6 month | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| duration, site and severity of bleeding effect of duration, site and severity of bleeding | behavioral and/or minimal neurological deficits and duration, site and severity of bleeding | 6 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Chronic ITP, Cerebral dysfunction