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Clinical practice: immune thrombocytopenia in paediatrics

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Abstract

Immune thrombocytopenia (ITP) is a disease affecting both children and adults. It is defined as acquired isolated thrombocytopenia caused by the autoimmune production of anti-platelet antibodies. Childhood ITP most frequently occurs in young children who have been previously well, although a viral respiratory tract infection often precedes thrombocytopenia. A benign and self-limiting course is common, but major bleeding complications such as intracranial haemorrhage may occur. Yet one cannot predict which child will have a prolonged course of thrombocytopenia and who will develop an intracranial haemorrhage. In children without atypical characteristics, only minimal diagnostic investigations are needed, and most paediatric ITP patients do not need platelet-enhancing therapy even though various treatment options are available. A “watch and wait” strategy should be considered in paediatric patients with mild disease. Steroids, intravenous immunoglobulin G or anti-D immunoglobulin are the current first-line therapeutic measures for children at risk for severe bleeding. When life-threatening bleeding occurs, a combination of therapies is needed. In this review, we summarise the current knowledge on primary ITP in children and adolescents.

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Abbreviations

ANA:

Antinuclear antibodies

EDTA:

Ethylenediaminetetraaceticacid

ICH:

Intracranial haemorrhage

IgG:

Immunoglobulin G

ITP:

Immune thrombocytopenia

IVIG:

Intravenous immunoglobulin G

IWG:

International Working Group

MMR:

Measles, mumps and rubella

TPO:

Thrombopoietin

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  1. Department of Paediatric Haemato-Oncology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium

    Veerle Labarque & Chris Van Geet

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  1. Veerle Labarque
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Correspondence to Veerle Labarque.

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Labarque, V., Van Geet, C. Clinical practice: immune thrombocytopenia in paediatrics. Eur J Pediatr 173, 163–172 (2014). https://doi.org/10.1007/s00431-013-2254-6

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