When Your Child Has Immune Thrombocytopenia (ITP)

What are the types of ITP?

Two types of ITP can occur. They are:

• 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, but 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)

• Nosebleeds

• Bleeding gums

• Bleeding in urine or stool

• Bruises in mouth (often called blood blisters)

• Signs of bleeding in the brain, including trouble with balance and coordination, abnormal walk, memory loss, and confusion

How is ITP diagnosed?

The provider will examine your child. They 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:

• Complete blood count (CBC). This measures the amounts of different types of cells in the blood. With ITP, the platelet count is especially important and other blood cells are typically normal.

• Blood smear. This is done to check the sizes and shapes of the blood cells.

• Bone marrow aspiration and biopsy. In rare cases, this 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. These may be done to rule out possible underlying conditions.

How is ITP treated?

With ITP, routine blood tests may be done to check your child's platelet count.

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 provider to manage any bleeding symptoms and to see if platelet counts return to normal on their own.

• Discuss with the provider how to help your child reduce the risk of bleeding and possible complications. This includes limiting certain physical activities and avoiding certain medicines.

• If treatment is needed, this can include:

  • Intravenous immune globulin (IVIG), Rh immune globulin, or corticosteroids (such as prednisone or dexamethasone) to help keep the body from destroying platelets

  • Other medicines 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, they will need ongoing monitoring and medical care. Work closely with the healthcare provider to learn how to help your child.