Guidelines for management of idiopathic thrombocytopenic purpura. The British Paediatric Haematology Group.

Guidelines for management of idiopathic thrombocytopenic purpura 0 B Eden, J S Lilleyman on behalf of the British Paediatric Haematology Group Children with idiopathic (immune) thrombo- cytopenic pupura (ITP) are almost invariably admitted to hospital for diagnosis. The usual presentation is an acute onset of bruising, purpura and petechiae or, less commonly, with mucosal bleeding from gums, nose, or rectum. Serious mucosal bleeding is unusual in un- complicated ITP and should provoke a search for other causes. The majority of patients (80%) will provide a history of some infection, usually viral, within the preceding three weeks. The peripheral blood normally shows simple thrombocytopenia without other abnormality, although some idividuals have a modest relative or absolute lymphocytosis. In 75% of cases the platelet count returns to normal within 3 months (90% by 9-12 weeks), but a history of bruising for one to two weeks before diagnosis often suggests a more chronic course is likely.