idiopathic thrombocytopenic purpura, ITP

This is an autoimmune condition in which antibodies are formed against the body's own platelets - cells that form clots and stop bleeding. It is thought to usually follow an infection, during which the immune system forms the abnormal antibodies in the course of fighting the infection. The antibodies cause the immune killer cells to mistakenly identify the normal platelets as foreign invaders, leading to their rapid destruction.

The first sign is very easy and extensive bruising. Large areas of deep bruising may form on the skin (purpura), without any history of injury. Petechiae will in all likelyhood appear.

A blood count will rapidly show that the platelet count is dramatically low, but that the other blood cells are not affected. A bone marrow test may be done to confirm the diagnosis, but many times this is only done if the child does not respond to therapy. If there is suspicion that the low platelet count may be an early sign of leukemia, a bone marrow would definitely be done.

Treatment usually consists of steroids, given intravenously or later orally. Treatment with intravenous gamma globulin (IVIg) is also an option, especially if response to steroids is not prompt. The "logical" treatment - to simply give platelet transfusions - does not work, because the antibodies cause the new platelets to be destroyed about as fast as they can be infused.

The most feared complication of ITP is brain hemorrhage (intracranial hemorrhage). Children with ITP have to be prevented from engaging in activities that could lead to a blow to the head and subsequent hemorrhage, at least until the platelet count rises sufficiently. Easier said than done with toddlers.

idiopathic - we do not know the cause (at least not until recently)
thrombocytic - thrombus, clot + cyte, cell - "clotting cells"
purpura - big purple bruises

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