Immune thrombocytopenia (ITP) In children

Question 1

what is it ?

Answer 1

is an immune-mediated reduction in the platelet count. Antibodies are directed against the glycoprotein IIb/IIIa or Ib-V-IX complex.

Question 2

what type of hypersensitivity reaction is it?

Answer 2

It is an example of a type II hypersensitivity reaction.

Question 3

onset in kids

Answer 3

more acute than in adults

Question 4

causes

Answer 4

may follow an infection or vaccination.

Question 5

features

Answer 5

bruising
petechial or purpuric rash
bleeding is less common and typically presents as epistaxis or gingival bleeding

Question 6

Ix

Answer 6

1. full blood count
   should demonstrate an isolated thrombocytopenia
2. blood film

Question 7

when is a bone marrow examination required?

Answer 7

bone marrow examinations is only required if there are atypical features e.g.
-lymph node enlargement/splenomegaly, high/low -white cells
-failure to resolve/respond to treatment

Question 8

Mx

Answer 8

conservative

avoid activities that may cause trauma e.g. sport

Question 9

Mx if platelet count is very low e.g. <10x10^9/l or significant bleeding

Answer 9

oral/IV corticosteroid

IV immunoglobulins

platelet transfusions can be used in an emergency (e.g. active bleeding) but are only a temporary measure as they are soon destroyed by the circulating antibodies