Lightning Learning: Immune Thrombocytopenia (ITP)
Primary Immune Thrombocytopenia (ITP) is an acquired immune mediated disorder characterised by isolated thrombocytopenia.
Defined as a peripheral blood platelet count of less than 100 x 109/L in the absence of any obvious initiating or underlying cause.
ITP typically presents with…
…sudden appearance of a petechial rash
…and/or spontaneous bruising
…and/or bleeding in an otherwise well child.
Secondary ITP refers to immune-mediated thrombocytopenia with an underlying cause, including drug-induced, or associated with systemic illness.
The incidence in children is approximately 4 in 100,000 in the UK. Whilst most cases are minor and require no treatment, the primary cause of mortality and morbidity is haemorrhage (including ICH).
History should be focused on assessing the risk or extent of bleeding and excluding other causes:
Type, severity and duration of bleeding
Presence of systemic symptoms such as fever, anorexia, bone or joint pain and weight loss (malignancy)
History of recent viral infection is common
Exposure to relevant drugs (e.g. Phenytoin, Valproate, Carbamazepine, Vancomycin, Septrin)