title: Clinical practice: immune thrombocytopenia in paediatrics.
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.
authors.affiliation: Department of Paediatric Haemato-Oncology, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium, veerle.labarque@uzleuven.be.
authors.forename: Veerle
authors.initials: V
authors.lastname: Labarque
authors.forename: Chris
authors.initials: C
authors.lastname: Van Geet
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D001323:Autoantibodies / Q000097:blood; D001792:Blood Platelets / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007116:Immunization, Passive; D007074:Immunoglobulin G / Q000627:therapeutic use; D020300:Intracranial Hemorrhages / Q000209:etiology / Q000276:immunology / Q000517:prevention & control; D007518:Isoantibodies / Q000627:therapeutic use; D011379:Prognosis; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000150:complications / Q000175:diagnosis* / Q000276:immunology / Q000628:therapy; D012141:Respiratory Tract Infections / Q000150:complications; D018029:Rho(D) Immune Globulin; D012307:Risk Factors; D057832:Watchful Waiting
chemical_list: D000305:Adrenal Cortex Hormones; D001323:Autoantibodies; D007074:Immunoglobulin G; D007518:Isoantibodies; C061961:RHO(D) antibody; D018029:Rho(D) Immune Globulin