European Journal of Pediatrics

, Volume 173, Issue 2, pp 163–172

Clinical practice: immune thrombocytopenia in paediatrics

Review

Abstract

Immune thrombocytopenia (ITP) is a disease affecting both children and adults. It is defined as acquired isolated thrombocytopenia caused by the autoimmune production of anti-platelet antibodies. Childhood ITP most frequently occurs in young children who have been previously well, although a viral respiratory tract infection often precedes thrombocytopenia. A benign and self-limiting course is common, but major bleeding complications such as intracranial haemorrhage may occur. Yet one cannot predict which child will have a prolonged course of thrombocytopenia and who will develop an intracranial haemorrhage. In children without atypical characteristics, only minimal diagnostic investigations are needed, and most paediatric ITP patients do not need platelet-enhancing therapy even though various treatment options are available. A “watch and wait” strategy should be considered in paediatric patients with mild disease. Steroids, intravenous immunoglobulin G or anti-D immunoglobulin are the current first-line therapeutic measures for children at risk for severe bleeding. When life-threatening bleeding occurs, a combination of therapies is needed. In this review, we summarise the current knowledge on primary ITP in children and adolescents.

Keywords

Immune thrombocytopenia Children ITP Purpura Idiopathic 

Abbreviations

ANA

Antinuclear antibodies

EDTA

Ethylenediaminetetraaceticacid

ICH

Intracranial haemorrhage

IgG

Immunoglobulin G

ITP

Immune thrombocytopenia

IVIG

Intravenous immunoglobulin G

IWG

International Working Group

MMR

Measles, mumps and rubella

TPO

Thrombopoietin

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Department of Paediatric Haemato-OncologyUniversity Hospitals LeuvenLeuvenBelgium

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