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Immune Thrombocytopenia in Children

Medically reviewed by Last updated on Feb 6, 2023.

What is immune thrombocytopenia?

Immune thrombocytopenia is a bleeding disorder. Immune thrombocytopenia may happen when your child's immune system attacks and destroys his or her 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 your child's body. Immune thrombocytopenia may also be called idiopathic thrombocytopenia or ITP.

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 (MMR)

What are the signs and symptoms of immune thrombocytopenia?

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

  • 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 adolescent girls

How is immune thrombocytopenia diagnosed?

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

How is immune thrombocytopenia treated?

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. Your child's healthcare provider will decide if he or she needs treatment. Treatment will depend on your child's platelet levels and symptoms. His or her platelet levels will be monitored closely with or without treatment. He or she may 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 or her blood clot.
  • Surgery to remove your child's spleen is rarely needed but may be done to stop his or her body from destroying platelets.

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

View more treatment options

What can I do to help my child prevent or manage bleeding?

  • Care for cuts, scrapes, or nosebleeds. Examine your child's skin for minor bumps, scrapes, and cuts. These injuries can increase your child's risk for bleeding that can become life-threatening. Apply firm, steady, pressure to cuts or scrapes. Use gauze or a clean towel. If possible, elevate the body part above the level of your child's heart. If your child's nose bleeds, pinch the top of his or her nose until bleeding stops.
  • Be careful with skin and mouth care. Use a soft washcloth when you bathe your younger child. Use a soft toothbrush to keep his or her gums from bleeding. Use lip balm to prevent his or her lips from cracking. Apply lotion to dry skin. Keep your child's nails trimmed. Teach your older child how to care for his or her skin and mouth. If your adolescent shaves his face, have him use an electric shaver.
  • Teach your child not to strain when he or she has a bowel movement. The strain can increase pressure in your child's brain and cause bleeding. Ask your child's healthcare provider about a stool softener or laxative to prevent or treat constipation. Do not use enemas or suppositories.
  • Use a cool mist humidifier to increase moisture in your home. Moisture may help prevent coughing or nosebleeds. Coughing can increase pressure in your child's brain and could cause bleeding.
  • Have your child avoid activities that may cause scratches or bruises. He or she may not be able to play contact sports such as football, hockey, or wrestling. Ask your child's healthcare provider which activities are safe for him or her.
  • Do not give your child aspirin or NSAIDs. These medicines can cause your child to bleed and bruise more easily.

What do I need to know about medical alert identification?

Have your child wear jewelry or carry a card that says he or she has immune thrombocytopenia. Ask your child's healthcare provider where to get these items.

Medical Alert Jewelry

Call your local emergency number (911 in the US) if:

  • Your child falls and hits his or her 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 or her head.
  • Your child has sudden weakness, numbness, or problems with his or her 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 call my child's doctor?

  • Your child has a fever.
  • Your child is bleeding from his or her gums, mouth, or nose.
  • Your child has abdominal pain.
  • Your child has blood in his or her 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

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.