Thrombocytopenic Purpura In Children

What is thrombocytopenic purpura?

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 also 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. Infants with ITP often show signs of bleeding three days after being born. Most babies and children with mild ITP usually get well after 3 to 12 months. Some children may have chronic (long-term) ITP, where bruising or bleeding may go on for years.

What causes thrombocytopenic purpura?

Caregivers do not exactly know what causes ITP. It is thought that problems in the body's immune system may cause ITP. The immune system is the part of the body that fights infection. ITP in newborns occurs when antibodies from the mother are passed on to the baby. Any of the following may trigger the immune system to cause ITP:

  • Severe bacterial infections, necrotizing enterocolitis (swelling of the intestines), or viral infections.

  • Vaccines, such as those given to prevent measles, mumps and rubella.

  • Medicines, such as antibiotics and medicine used to control seizures.

What are the signs and symptoms of thrombocytopenic purpura?

Signs and symptoms of mild to moderate ITP may include any of the following:

  • Petechiae (pinpoint reddish spots in the body).

  • Purpura (purple-colored patches of bruising).

  • Bleeding from the gums, mouth or nose.

  • Blood in the stools (bowel movements) or dark-colored stools.
In severe cases where there may be bleeding in the brain, the signs and symptoms may include:
  • Bulging of the soft spot (fontanels) on the head in infants.

  • Drowsiness or difficulty waking up.

  • Repeated or forceful vomiting (throwing up).

  • Seizures (convulsions).

  • Sudden changes in personality.

  • Sudden weakness or numbness, or problems with balance and movement.

  • Trouble seeing (blurry or double vision), talking, or hearing.

How is thrombocytopenic purpura diagnosed?

Your child may have any of the following tests:

  • 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.

How is thrombocytopenic purpura treated?

Your child may have any of the following:

  • Watchful waiting: Mild ITP often gets better on its own within six months without treatment. Caregivers may want your child to have frequent check ups. This is to see if your child's ITP would go away on its own before starting any treatment.

  • 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.

  • 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 the system fights something in your blood or body that it should not. Ask your child's caregiver for more information about how immune globulin medicine may help.

  • 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.

What can I do to help my child?

  • Ask your child's caregiver before giving any medicines to your child. Do not give your child aspirin, ibuprofen, or antihistamines, as these medicines may cause bleeding.

  • Do not allow your child to join in rough play or contact sports. These activities may cause bruising or head injury, and lead to serious bleeding problems.

  • If your child is having hard, dry stools that are difficult to pass, he may be constipated. Constipation can cause bleeding in your child's bowel movement (BM). Give your child fresh fruit and plenty of water to drink to avoid constipation. Ask your child's caregiver for more information about preventing and treating constipation.

  • Have your child wear a medical alert bracelet or necklace saying that he has thrombocytopenic purpura. You may get one from the local drugstore or contact the MedicAlert Foundation:
    • MedicAlert Foundation
      2323 Colorado Avenue
      Turlock , CA 95382
      Phone: 1- 888 - 633-4298
      Web Address:

  • Give your child a soft-bristled toothbrush, and teach him to brush his teeth slowly and gently. Doing this may help prevent bleeding gums. Have your child use lip balm to prevent his lips from drying and cracking.

  • Use lotion on your child's dry skin to prevent itching and scratching, which may lead to bruising.

Where can I find support and more information?

Having thrombocytopenic purpura may be a life-changing disease for you, your child, and your family. Accepting that your child has thrombocytopenic purpura may be hard. You and those close to you may feel angry, sad, or frightened. These feelings are normal. Talk to your caregivers, family, or friends about your feelings. You may also want to join a support group for people who have thrombocytopenic purpura. Contact the following for more information:

  • National Heart, Lung and Blood Institute
    Health Information Center
    P.O. Box 30105
    Bethesda , MD 20824-0105
    Phone: 1- 301 - 592-8573
    Web Address:
  • National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
    Building 31, room 9A04 Center Drive, MSC 2560
    Bethesda , MD 208922560
    Web Address:
  • American Academy of Family Physicians
    11400 Tomahawk Creek Parkway
    Leawood , KS 66211-2680
    Phone: 1- 913 - 906-6000
    Phone: 1- 800 - 274-2237
    Web Address:

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. 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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