An 8-year-old child is admitted with severe epistaxis. She has a generalized pur

Question

An 8-year-old child is admitted with severe epistaxis. She has a generalized purple petechial rash that developed over the last 24 hours. She also has hemorrhage bullae on her gums and lips. Her parents state that "she just started to bleed before our eyes." She denies any recent injuries. Her parents report that she just got over a bad cold. Her lab work shows abnormal bleeding time, thrombocytopenia, normal granulocytes, and low normal hemoglobin and hematocrit. What type of disorder does this child have, and what is the pathophysiology?

Explanation / Answer

The child is suffering with idiopathic thrombocytopenic purpura (ITP).

It is primarily a disease with increased platelet destruction. In this disease antibody coated platelets are destroyed by macrophages. As a result the platelet life span is shortened and it leads to thrombocytopenia.

Usually in ITP the antiplatelet antibodies are developed through the activation of B lymphocytes. these antibodies directed against platelet glycoproteins. they affect the Alia lineage megakaryocytes and Empire the production of platelets in bone marrow.

In children the instance is very rare like 3-8 cases per 100000 children per year. In young children the acute ITP is more common.

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