Immune Thrombocytopenia (ITP) in Children
Immune thrombocytopenia (ITP) is when the body’s immune system attacks and destroys platelets, the blood cells that cause blood clots to form and help control bleeding.
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The immune system produces antibodies that attach to the platelets and destroy them. This results in a low platelet count, causing easy bruising, internal bleeding or bleeding gums.
ITP can develop in children and adults, but there are key differences in prevalence, remission rates and treatment options.
In the United States, about four to eight children in 100,000 under the age of 15 have one of the two forms of ITP:
Acute thrombocytopenic purpura is the most common form of the disorder in children and is usually seen in children ages 2 to 6. Symptoms may follow a viral illness, such as chicken pox, and often develop suddenly. Symptoms usually disappear in less than six months, and often within a few weeks, and does not recur.
Chronic thrombocytopenic purpura can happen at any age, and symptoms can last from six months to several years. This type of ITP is more common in adults, but does affect adolescents. Chronic ITP can recur often and requires continual follow-up care with a hematologist.
Symptoms of ITP in Children
Symptoms of ITP include:
- Easy or excessive bruising
- Tiny reddish-purple dots that look like a rash, called petechiae
- Bleeding from the gums or nose
- Blood in vomit, urine or stools
- Bleeding in the head
Treatment and Management of ITP
Not all children with ITP need treatment. Your child’s physician may advise close monitoring of your child’s platelet counts, while avoiding situations that could likely result in bleeding.
If your child’s physician recommends treatment, the two most common are:
- Steroids, which can help prevent bleeding by decreasing the rate of platelet destruction, often within a few weeks.
- Intravenous gamma globulin (IVGG), a protein that contains many antibodies and also slows platelet destruction.
Other treatments for children with ITP can include:
- Immune globulin
- Medication changes
- Infection treatment
- Splenenctomy
- Hormone therapy
Although there is no known cause of ITP and no cure, the prognosis for a child with ITP is very good. Usually, the child’ body stops making the antibodies that are attacking the platelets and the disorder goes away on its own.