UMEM Educational Pearls

Category: Pediatrics

Title: Idiopathic Thrombocytopenic Purpura (ITP)

Posted: 8/18/2010 by Rose Chasm, MD (Emailed: 8/28/2010) (Updated: 9/24/2021)
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  • most common cause of low platelets in children
  • immune-mediated destruction of circulating platelets
  • acute ITP peak incidence between 2-5 years of age; chronic ITP peaks in adolescence
  • recent history (1-6 weeks) of viral infection or immunization is common
  • no hepatosplenomegaly
  • low platelets with megathrombocytes on smear, with normal hemoglobin (which differentiates from TTP, HUS, and DIC)
  • nearly 90% of children will have normal platelet counts in 6 months
  • treatment reserved for platelet counts <20,000 or significant bleeding:  IVIG (best response rate of 95%), corticosteroids (79% resposne rate), anti-rH (D) immunoglobulin (82% reesponse reate)

References

MedStudy Pediatrics Board Review, Book 4, 1st edit