Clinical manifestations of ITP in children

Abstract

Most cases of idiopathic thrombocytopenic immune thrombocytopenia purpura (ITP) in children occur before 5 years old, show spontaneous remission under careful observation, and resolve with the use of first-line treatments such as steroids or high-dose immunoglobulin. ITP often develops after viral or bacterial infection, or after vaccination. Severe bleeding symptoms and severe thrombocytopenia (<20 x 109/L) are rare but often become refractory. Second-line treatments such as rituximab and thrombopoietin receptor agonists have recently been used for ITP in children, in place of splenectomy. An objective ITP-bleeding assessment score seems necessary for management guidelines and selection of objective treatment in the future.