Factors associated with chronicity in children with immune thrombocytopenia in Inner Mongolia

To investigate the related factors influencing the progression of immune thrombocytopenia (ITP) to chronic immune thrombocytopenia (cITP) in children, aiming to evaluate their potential value in early risk stratification and prognosis assessment. Clinical data from pediatric ITP patients at 12 tertiary hospitals in Inner Mongolia, collected between January 2018 and September 2025 were analyzed. Through univariate and binary logistic regression analysis, we identified independent factors influencing the prognosis of children. (1) General information: A total of 549 patients were included, comprising 290 males (52.82%) and 259 females (47.18%), with a male-to-female ratio of 1.12:1. Among them, 146 (26.6%) developed chronic ITP, while 403 (73.4%) were non-chronic. (2) Univariate analysis showed that age, triggering factors (infection and/or vaccination), platelet count (PLT) at initial diagnosis, absolute lymphocyte count (ALC), T lymphocyte count, CD4⁺ T lymphocyte count, natural killer (NK) cell count, bone marrow megakaryocyte (MK) count, antinuclear antibody (ANA), and initial treatment modality were significantly associated with prognosis (P < 0.05). (3) Multivariate logistic regression revealed that age, CD4⁺ T lymphocyte count, and ANA positivity were independent factors for chronicity in pediatric ITP (P < 0.05). Children with ITP who were older at diagnosis and had a positive ANA were more likely to progress to chronic ITP; the higher CD4⁺ T lymphocyte counts may be protective. These factors may assist in early risk stratification and help identify patients requiring closer monitoring, thereby providing a reference for prognosis evaluation. However, their role in guiding individualized treatment strategies requires further validation in prospective studies.