Thrombocytopenic Purpura In Children

What is thrombocytopenic purpura?

Thrombocytopenic purpura is a bleeding disorder. Your child's immune system may have antibodies against his platelets. Platelets are cells that help blood to clot. The antibodies attach to his platelets, and then his spleen destroys the platelets. You may not know that your child has thrombocytopenic purpura early in the disease. Symptoms are often mild, but bleeding can be severe at times and become life-threatening.

What increases my child's risk for thrombocytopenic purpura?

  • A recent bacterial or viral infection

  • An immune system disorder

  • Vaccines, such as those for measles, mumps, and rubella

  • Medicines, such as antibiotics and medicine for seizures

What are the signs and symptoms of thrombocytopenic purpura?

Your child's signs and symptoms will depend on his platelet count. He may bleed or bruise more easily or have tiny red or purple spots on his skin. He may have blood in his urine or bowel movement, or bleed from his gums or nose. If thrombocytopenia becomes severe, the soft spots (fontanelles) on your child's head may bulge. He may seem very drowsy or difficult to wake up. He may vomit repeatedly or have a seizure.

How is thrombocytopenic purpura diagnosed?

  • Blood tests are done to count your child's platelets and time how long it takes his blood to clot.

  • A bone marrow biopsy will show if your child's bone marrow is making platelets normally.

How is thrombocytopenic purpura treated?

Treatment will depend on your child's symptoms. Your child's healthcare provider may recommend that he have frequent tests and regular follow-up visits to watch for changes. He may need any of the following:

  • Medicines help your child's immune system and decrease destruction of platelets. Medicine may also be given to help increase platelet production and prevent bleeding.

  • Platelet transfusions may be given if your child's platelets are very low, or healthcare providers need to stop severe bleeding.

  • Surgery to remove your child's spleen may be needed to stop platelet destruction if his condition is severe.

How can I care for my child when his platelets are low?

Examine your child's skin for minor bumps, scrapes, and cuts. Injuries can increase his risk for bleeding.

  • Use caution with skin and mouth care. Use a soft washcloth and a soft toothbrush to prevent your child's skin and gums from bleeding. Have your child use lip balm to prevent his lips from cracking.

  • Prevent constipation. Constipation can increase pressure in your child's brain and could cause bleeding. Ask your child's healthcare provider how much liquid he should drink. Ask about a stool softener or laxative if he is constipated. Do not use enemas or suppositories.

  • Have your child avoid activities that may cause scratches or bruises. Have him wear shoes or slippers to protect his feet from injury. Ask your child's healthcare provider which activities are safe for him.

  • Do not give your child aspirin or NSAIDs. These medicines can cause him to bleed and bruise more easily.

  • Have your child wear medical alert jewelry or carry a card that says he has thrombocytopenic purpura. Ask your child's healthcare provider where to get these items.

When should I contact my child's healthcare provider?

  • Your child has a fever.

  • Your child is bleeding from his gums, mouth, or nose.

  • Your child has abdominal pain.

  • Your child's bowel movement has blood in it or is dark.

  • Your child has a sudden, severe headache.

  • You have questions or concerns about your child's condition or care.

When should I seek immediate care or call 911?

  • Your child has a head injury.

  • Your child has a seizure.

  • Your child is drowsy or will not wake up.

  • Your child is confused or has problems seeing, talking, or hearing.

  • Your child vomits repeatedly.

  • Your baby has a bulging soft spot (fontanel) on his head.

  • Your child has sudden weakness, numbness, or problems with his balance and movement.

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.

© 2014 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.

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