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Immune Thrombocytopenic Purpura, Pediatric

L. Charles Bailey, MD, PhD Reviewed 10/2018
 


BASICS

DESCRIPTION

  • Immune thrombocytopenic purpura (ITP) is an autoimmune syndrome characterized by the following:

    • Isolated thrombocytopenia (platelet count formally <100,000/mm3, typically <20,00...

DIAGNOSIS

HISTORY

  • Presents with increased bruising (with minor or no trauma, or in uncommon locations such as torso, neck, face), petechiae, epistaxis, prolonged bleeding with minor trauma, gingival bl...

TREATMENT

  • Because severe hemorrhage is rare and ITP resolves spontaneously in 90% of pediatric cases, most children without severe bleeding will not require treatment.

  • Treatment slows antibody-mediated...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Platelet count 1 to 2 times weekly when <20,000/mm3, biweekly when <50,000/mm3 or after treatment, except in stable chronic ITP. More freq...

ADDITIONAL READING

  • Arnold DM. Bleeding complications in immune thrombocytopenia. Hematology Am Soc Hematol Educ Program.  2015;2015:237–242. [View Abstract on OvidInsights]

  • Eberl W, Dickerhoff R; ...

CODES

ICD9

  • 287.31 Immune thrombocytopenic purpura

  • 287.32 Evans’ syndrome

  • 287.3 Primary thrombocytopenia

ICD10

  • D69.3 Immune thrombocytopenic purpura

  • D69.41 Evans syndrome

SNOMED

  • 32273002 Idiopathic thrombocyto...

FAQ

  • Q: Do children with ITP and very low platelet counts (<10,000/mm3) require prophylactic treatment?

  • A: Although there is some evidence that bleeding risk is higher with platelet counts <10,000...

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