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Immune Thrombocytopenia in Children


What is immune thrombocytopenia?

Immune thrombocytopenia is a bleeding disorder. Immune thrombocytopenia may happen when your child's immune system attacks and destroys his platelets. This causes low platelet levels. Platelets are cells that help the blood clot and stop bleeding. When platelet levels are low, bleeding may occur anywhere in the body. Immune thrombocytopenia may also be called idiopathic thrombocytopenia or ITP. Most ITP in children will get better in a few weeks to months. Medicines may be needed to treat ITP, or it may get better on its own. ITP in children can last for several months to years and can become a chronic condition.

What increases my child's risk for immune thrombocytopenia?

  • A recent viral infection or bacterial infection such as measles or H pylori
  • An immune system disorder
  • Medicines that may cause low platelet levels, such as antibiotics or medicine for seizures
  • Rarely, vaccines, such as those for measles, mumps, and rubella

What are the signs and symptoms of immune thrombocytopenia?

Your child's signs and symptoms will depend on his platelet count. He may have no symptoms if his platelet levels are normal. He may have any of the following:

  • Bruising or red or purple spots on the skin or mucus membranes
  • Bleeding from the gums or nose
  • Blood in the urine or bowel movements
  • Heavy menstrual bleeding in adolescents

How is immune thrombocytopenia diagnosed?

Your child's healthcare provider will examine him and ask about his symptoms. Tell him about any medicines or supplements that your child takes. Blood tests will be done to check your child's platelet levels and how fast his blood clots.

How is immune thrombocytopenia treated?

Your child's healthcare provider will decide if he needs treatment. Treatment will depend on your child's platelet levels and symptoms. He will need his platelet levels monitored closely with or without treatment. He me need any of the following:

  • Medicines may be given to prevent your child's immune system from destroying platelets. Medicine may also be given to help increase platelet levels and prevent bleeding. Medicines may be given as a pill or through an IV.
  • Platelet transfusions may be given if your child's platelet levels are low. Platelet transfusions may also be given to help stop heavy bleeding. Your child may need platelet transfusions before surgery or procedures to help his blood clot.
  • Surgery to remove your child's spleen is rarely needed but may be done to stop his body from destroying platelets.

What can I do to care for my child?

  • Care for your child's skin. Use a soft toothbrush to prevent your child's gums from bleeding. Have your child use lip balm to prevent his lips from cracking. Use a soft washcloth during baths or showers. Apply lotion to his dry skin. Do not cut his nails too short. Have your child wear slippers or shoes to protect his feet.
  • Do not let your child do activities that may cause injury. Ask your child's healthcare provider which activities are safe for him. Your child may not be able to play contact sports such as hockey, football, or boxing.
  • Do not give your child aspirin or NSAIDs. These medicines can stop platelets from working well. This may cause him to bleed and bruise more easily.
  • Care for your child's cuts, scrapes or nosebleeds. Apply firm, steady, pressure to cuts or scrapes. Use gauze or a clean towel. If possible, elevate the body part above the level of his heart. If your child's nose bleeds, pinch the top of his nose and his nostrils. Do this until bleeding stops.
  • Have your child carry medical alert identification. Have him wear jewelry or carry a card that says he has immune thrombocytopenia. Ask your child's healthcare provider where to get these items.

Call 911 for any of the following:

  • Your child falls and hits his head.
  • Your child has a seizure.
  • Your child cannot be woken.
  • Your child has trouble breathing.

When should I seek immediate care?

  • Your child has a sudden, severe headache.
  • 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.
  • Your child's bleeding does not stop or becomes heavier.
  • Your child's arm or leg looks bigger, feels warm, and is painful.

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 has blood in his urine or bowel movement.
  • You see new bruises or small red or purple spots on your child's skin.
  • You have questions or concerns about your child's condition or care.

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 healthcare providers 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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Further information

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