Kids Health Info

Idiopathic Thrombocytopenic Purpura ITP

  • Idiopathic thrombocytopenic purpura, or ITP, is a bleeding disorder resulting from a shortage of platelets in the blood. Platelets are the blood cells that help the blood to clot.  If a child has a shortage of platelets then he or she will bruise easily and may have other bleeding problems.

    The disease is caused when the spleen and lymph tissues produce antibodies against platelets. Antibodies are proteins that are produced by the immune system. The antibodies destroy the platelets in the spleen. We do not fully understand why the body has this reaction. In children, the disease is sometimes preceded by a viral infection (e.g. a cold), and this seems to be a trigger for the production of abnormal antibodies.

    ITP is more common in children than adults. ITP occurs in one in every 10,000 children, so it is quite rare.

    It is important for you to know that the risk of any serious complication from ITP is very low.

    In most children the condition will settle down quite quickly. The platelet count is often up to safe levels within a week or two, but it may take longer to fully return to normal. In a very small number of children, the platelet count does not return to normal, even after six to 12 months.  In these cases, further treatment may be advised.

    Signs and symptoms

    • bruising
    • nosebleeds or mouth bleeding
    • petechial rash (pinpoint red spots) on the skin.

    Treatment

    There are several treatment options which your child's doctor will discuss:

    • No treatment - is a good option for many children. The condition will get better by itself.
    • Steroids (prednisolone) - can raise the platelet count more quickly than would occur with no treatment.
    • Intravenous gamma globulin - is a type of blood transfusion that is sometimes used, but it may cause side effects.

    The doctor will discuss the best treatment option for your child. You may need to attend for blood tests every few days to monitor the progress of the condition. It is important that you attend all the follow up appointments.

    Care at home

    • Children with ITP should not take aspirin or ibuprofen (an anti-inflamatory, e.g. Nurofen), because these medicines may cause bleeding. Paracetemol is quite safe to use.
    • While your child's platelet count is very low, he or she may be advised to avoid activities which might cause bruising or bleeding (e.g. stay off the climbing equipment or bicycle).
    • As the platelet count rises, more activity will be allowed.  However, contact sports, cycling and other rough physical activity may need to be avoided until your child's doctor advises that it is safe.

    Key points to remember about ITP

    • It is a bleeding disorder that is caused when the blood has difficulty clotting because of a shortage of platelets.
    • It is more common in children than adults.
    • In most cases, ITP will settle quickly with no treatment.
    • Serious complications with ITP are very rare.

    More information

    Developed by the RCH Department of General Medicine in consultation with Haematology. First published 2004. Updated December 2010.


Disclaimer 
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.