When Your Child Has Idiopathic Thrombocytic Purpura (ITP)
Idiopathic thrombocytic purpura (ITP) is a blood disorder that affects the platelets. Platelets (also called thrombocytes) are blood cells that help with clotting. Normally, when your child has a cut or bruise, platelets come together to form a clot or "plug" to stop or control bleeding. With ITP, there are not enough platelets. As a result, your child can have more bleeding or bruising than normal. Your child's healthcare provider can evaluate your child and discuss treatment options with you.
What are the types of ITP?
Two types of ITP can occur. They include:
Acute ITP. This type can last up to 6 months. It occurs more often in toddlers or young children.
Chronic ITP. This type can last 6 months or longer. It occurs more often in adults, though it can also affect children.
What causes ITP?
The cause of ITP is unknown. It is believed to be an autoimmune disorder. This is because the body's immune system attacks normal platelets.
What are the symptoms of ITP?
Symptoms vary for every child. Symptoms may include:
Small red or purple spots (petechiae) that look like a rash
Bruising that is often purple (purpura)
Bleeding in urine or stool
Bruises in mouth (often called blood blisters)
Signs of stroke, including trouble with balance and coordination, abnormal walk, memory loss, confusion
How is ITP diagnosed?
The doctor will examine your child. He or she will ask about your child's symptoms and health history. Tests will also be done. Most of the tests require taking a blood sample from a vein in the arm or from a finger or heel. Tests may include:
A complete blood cell count (CBC) to measure the amounts of different types of cells in the blood. With ITP, the platelet count is especially important.
A blood smear to check the sizes and shapes of the blood cells.
Bone marrow aspiration and biopsy may be needed to check for problems with the production of blood cells. With a bone marrow aspiration, a needle is inserted into a bone to collect a sample of the bone marrow fluid and cells. With a bone marrow biopsy, a needle is inserted into a bone to collect a small sample of bone marrow tissue. In either case, the sample is analyzed in a lab.
Other lab tests may also be done to rule out possible underlying conditions.
How is ITP treated?
Treatment varies depending on your child's platelet count and the severity of your child's symptoms.
In many cases, no treatment is needed. Your child is monitored by the doctor to manage any bleeding symptoms and to see if platelet counts return to normal on their own.
Discuss with the doctor how to help your child reduce the risk of bleeding and possible complications. This includes topics such as limiting certain physical activities, and avoiding certain medicines.
If treatment is needed, this can include:
Intravenous immune globulin (IVIG) or Rh immune globulin to help keep the body from destroying platelets
Medicine to help raise the platelet count
Surgery to remove the spleen, which may be the site of platelet destruction
What are the long-term concerns?
Most children with ITP recover completely. If your child has chronic ITP, he or she will need ongoing treatments and medical care. Work closely with the doctor to learn how to help your child.
February 10, 2018
Immune thrombocytopenia (ITP) in children: clinical manifestations and diagnosis. UpToDate.
Adler, Liora, C., MD,Brown, Kim, APRN,Images Reviewed by Staywell medical art team.