ITP in children is often considered a different disease than ITP in adults because children usually recover more easily. However, ITP in adolescents is more like ITP in adults with a greater chance of it lasting a long time.
The most feared complication of ITP is intracranial hemorrhage, a bleed to the brain, like a stroke. Fortunately, this is rare, occurring in less than .5 to 1.0% of the children diagnosed with ITP.
About 4.3 to 5.3 per 100,000 children are diagnosed with ITP each year.1,2 Since children with ITP usually recover, the number of children who have ITP at any one time is about equal to those diagnosed annually.3
Because ITP is a diagnosis of exclusion, it is important to rule out other causes of low platelets and tell the doctor about events that could have triggered the low platelets.
The treatments for ITP in children can vary depending on the child’s platelet count, activity level and bleeding symptoms. Whatever the treatment regimen, it is important for the child to have as normal a life as possible. Because many children recover and the treatments can be difficult, some pediatric hematologists suggest a watchful waiting approach. The 2011 American Society of Hematology guidelines recommend that children be managed with observation alone if they have only mild or no bleeding symptoms, regardless of platelet count.4 New treatments for children are in Clinical Trials.
1. Fogarty PF, Segal JB. "The epidemiology of immune thrombocytopenic purpura." Curr Opin Hematol.2007;14: 515-519. http://www.ncbi.nlm.nih.gov/pubmed/17934361
2. Zeller B, Helgestad J, Hellebostad M, et al. "Immune thrombocytopenic purpura in childhood in Norway: a prospective, population-based registration." Pediatr Hematol Oncol. 2000;17(7):551-558.http://www.ncbi.nlm.nih.gov/pubmed/15981751
3. Segal JB, Powe NR. "Prevalence of immune thrombocytopenia: analyses of administrative data." J Thromb Haemost. 2006;4(11):2377-2383. http://www.ncbi.nlm.nih.gov/pubmed/16869934
4. Neunert C. “The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia.” Blood. April 21, 2011 vol. 117 no. 16 4190-4207.http://bloodjournal.hematologylibrary.org/content/117/16/4190.full