Does acute immune thrombocytopenia (ITP) in children always require treatment?

Updated: Nov 30, 2019
  • Author: Perumal Thiagarajan, MD; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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Because acute immune thrombocytopenia (ITP) in children is self-limited, most physicians do not routinely treat it. Treatment is necessary only to prevent intracranial or other serious internal hemorrhage. [20] The rate of intracranial hemorrhage is very low, possibly less than 0.1%, and occurs with platelet counts of 10,000-20,000/µL.

Most physicians arbitrarily treat children with ITP when their platelet count levels are less than 20,000/µL. Nevertheless, current guidelines from the American Society of Hematology recommend that children with no bleeding or mild bleeding (defined as bruising and petechiae, with no mucosal bleeding) be managed with observation alone regardless of platelet count. [16]

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