Thrombocytopenic Purpura In Children

WHAT YOU SHOULD KNOW:

Thrombocytopenic Purpura In Children (Inpatient Care) Care Guide

  • Thrombocytopenic purpura is a bleeding disorder where there are too few platelets in your child's blood. Platelets are blood cells that help stop bleeding by sticking together to form a clot. Thrombocytopenic purpura may be a childhood or neonatal (newborn) immune system problem. The cause of the condition may be unknown, and called idiopathic thrombocytopenic purpura, or ITP. ITP may occur in an otherwise healthy child who suddenly has signs of bleeding, such as bruising. This condition is usually seen after a viral (germ) infection, such as measles or chickenpox. Pregnant women with ITP may also pass on antibodies to her baby, causing neonatal thrombocytopenia.

  • Signs and symptoms often start with pinpoint reddish spots in the body. This is followed by purple-colored patches of bruising, and bleeding from the gums, mouth or nose. The bowel movements (BM) may have blood or are dark-colored. Blood tests are done to diagnose ITP. Most children with mild ITP get well within 3 to 12 months, and often do not need treatment. Medicines, such as steroids and immune globulins, may be given to treat severe ITP. Surgery to take out the spleen may also be done. Avoiding activities, medicines, and other things that cause bleeding may help your child to keep doing most of his usual activities.

CARE AGREEMENT:

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child.

RISKS:

Severe thrombocytopenic purpura may cause uncontrolled bleeding in the stomach and the brain, which may be life-threatening. ITP may even persist and cause a long-term condition called chronic ITP. Treatments, such as steroids, immune globulins and surgery, may have unpleasant side effects. Your child may have serious infections and further bleeding after surgery. Ask your child's caregivers for more information about your child's ITP and its different treatment options.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.

Emotional support:

Stay with your child for comfort and support as often as possible while he is in the hospital. Ask another family member or someone close to the family to stay with your child when you cannot be there. Bring items from home that will comfort your child, such as a favorite blanket or toy.

An IV

is a small tube placed in your child's vein that is used to give him medicine or liquids.

Medicines:

Your child may have any of the following:

  • Immune globulins: Immune globulins can be given to treat many different problems. It may be given to help your child's immune system fight infection. It may also help if his body does not produce enough of certain kinds of blood cells. This medicine may help if his immune system fights something in his blood or body that it should not. Ask your child's caregiver for more information about how immune globulin medicine may help.

  • Steroids: Steroid medicine may be given to decrease inflammation, which is redness, pain, and swelling. There are many different reasons to take steroids. With ITP, steroid medicine may prevent an immune system response. Be sure you understand why your child needs steroids, and do not stop using this medicine unless your child's caregivers tells you to.

Tests:

Your child may have one or more of the following:

  • Blood tests: Your child may need blood tests to give caregivers information about how his body is working. The blood may be taken from your child's arm, hand, finger, foot, heel, or IV.

  • Bone marrow biopsy: Bone marrow is the soft, spongy tissue inside the bone. During this procedure, a sample of bone marrow is removed and sent to the lab for tests. The skin over your child's upper hipbone is first cleaned. Caregivers put numbing medicine into your child's skin to decrease pain. The tissue sample is taken, and a bandage is put over the biopsy area.

Treatment options:

Your child's treatment may change if his signs and symptoms are not being controlled. This is often decided after he has tests. Your child may have any of the following:

  • Blood transfusion: During a blood transfusion, your child will get whole blood, or parts of blood through an IV. You may be worried that your child will get AIDS, hepatitis, or West Nile Virus from a blood transfusion. The risk of this happening is rare. Blood banks test all donated blood for AIDS, hepatitis, and West Nile Virus.

  • Surgery: Surgery to remove the spleen may be done. This surgery is called a splenectomy. Ask your child's caregiver for more information about surgery as a treatment for ITP.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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