en Pediatric Hematology & Oncology Pediatric Hematology & Oncology پژوهشي Original Article <div style="text-align: justify;"><span style="font-size:14px;"><span style="line-height:2;"><span style="font-family:Times New Roman;"><span new="" roman="" times=""><strong>Background: </strong>Immune thrombocytopenia (ITP) in children is often self-limiting, yet the risk of severe bleeding necessitates treatment. Corticosteroids remain the standard first-line therapy, though the optimal duration remains uncertain.<br> <strong>Objective: </strong>This study aimed to compare the efficacy and safety of a short-course oral prednisolone regimen with the conventional extended regimen in pediatric patients with newly diagnosed ITP.<br> <strong>Methods: </strong>In this open-label, randomized trial, 69 children aged 2 to 8 years with newly diagnosed ITP received either prednisolone 2 mg/kg/day for 7 days (short course) or 14 days followed by tapering to day 21 (extended course). Platelet counts were measured at baseline and on days 2, 7, 30, and 60.<br> <strong>Results:</strong> Thirty-five patients were randomized to the short course and 34 to the extended course. Platelet responses did not differ significantly at any time point (all p > 0.05). Complete response occurred in 80% and 85.3% of patients, respectively (p = 0.78). Baseline platelet count was the only independent predictor of response (p = 0.01).<br> <strong>Conclusion:</strong> A 7-day high-dose prednisolone regimen provides efficacy comparable to a 21-day extended course while minimizing cumulative corticosteroid exposure. These findings support short-course therapy as an effective, guideline-consistent first-line option in pediatric ITP.</span></span></span></span></div> Pediatric immune thrombocytopenia, Prednisolone, Short-course therapy, Extended regimen, Randomized clinical trial 1 8 http://ijbc.ir/browse.php?a_code=A-10-2276-4&slc_lang=en&sid=1 Fatemeh Malek No Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Nader Momtazmanesh No Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Sharareh Kamfarr No Pediatric Congenital Hematologic Disorders Research Center, Research Institute for Children’s Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Aziz Eghbali No Aliasghar Clinical Research Development Center, Department of Pediatrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. Khatere Tavajohi khtavajohi@gmail.com Yes Aliasghar Clinical Research Development Center, Department of Pediatrics, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.