Management of Childhood Immune Thrombocytopenic Purpura

Abstract

Immune Thrombocytopenic Purpura (ITP) is a common benign bleeding disorder in childhood. Several studies indicate that only few children experience serious bleeding while Intracranial Hemorrhage (ICH) is rare, occurring in less than 1%. The diagnosis of ITP is based principally on the history, physical examination, complete blood count which excludes other causes of thrombocytopenia. Bone marrow examination is not necessary in the straightforward cases and mandatory in typical cases. Steroid has been the standard treatment of acute ITP since long time. It was shown that treatment response did not differ significantly between patients treated with Intravenous Immunoglobulin (IVIG) and steroid although a more rapid increase in platelets count was observed after IVIG. ITP in pregnancy necessitates the management of two patients, the mothers and her baby. Chronic ITP occurs in 20-25% of children with acute ITP. Medical management is preferred over splenectomy. This review highlights the management guidelines of childhood ITP.