ITP 2020

Question 1

Most common age range to get ITP

Answer 1

Between 2-5

Question 2

Most serious complication of ITP

Answer 2

Intracranial hemorrhage

Question 3

Red flags for alternate ITP diagnoses

Answer 3

Constitutional symptoms
Bone pain
Recurrent thrombocytopenia
Poor treatment response
Lymphadenopathy
Hepato/splenomegaly
Unwell appearance
Signs of chronic disease

Question 4

Management for children with ITP WITHOUT active bleeding

Answer 4

Strongly consider observation as first line approach

Oral corticosteroids or IVIG second line option

Question 5

Management for children with ITP with MODERATE bleeding

Answer 5

Options include single dose of IVIG or short course of corticosteroids

Question 6

Management for children with ITP with SEVERE bleeding

Answer 6

Immediate treatment in hospital with IV steroids and IVIG
TXA may help as an adjunct (discuss with hematologist)
Platelet transfusion contraindicated except for acute, life threatening bleeds or in children requiring immediate surgery

Question 7

Can NSAIDs be used in patients recovering from ITP

Answer 7

Nope!

Question 8

Symptoms of ITP under “no or mild bleeding” category

Answer 8

Bruising, petechiae or occasional mild epistaxis
No or very little interference with daily living
May include non-oozing petechiae on oral mucosa or resolved mild epistaxis

Question 9

Symptoms of ITP under “moderate bleeding” category

Answer 9

More severe skin manifestations
Some mucosal lesions
More troublesome epistaxis or menorrhagia

Question 10

Symptoms of ITP under “severe bleeding” category

Answer 10

Bleeding episodes requiring hospital admission

Epistaxis, menorrhagia, and/or intracranial hemorrhage