Pediatr. praxi. 2022;23(5):326-329 | DOI: 10.36290/ped.2022.057

Immune thrombocytopenia in children

MUC. Karolína Šimková, MUDr. Petra Matalová, Ph.D.

Ústav farmakologie, LF UP a FN Olomouc

Immune thrombocytopenia (ITP) is a disease characterized by isolated thrombocytopenia without other abnormalities in the blood count and peripheral blood smear. ITP in children is divided into 2 categories. Primary ITP is an acquired disease with unknown cause. Secondary ITP occurs in a child as part of another disease. According to the duration, we can divide ITP into newly diagnosed (up to 3 months), persistent (3-12 months) or chronic (longer than 12 months). The pathogenesis involves the influence of cellular immunity, the action of antibodies, changes in megakaryopoiesis and a relatively low level of trombopoietin. ITP is largely a clinical diagnosis. For children with typical symptoms, it is a sudden onset of petechial rush and bruising. Initial therapy involves only ,,watchful waiting" or pharmacological intervention. Glucocorticoids and intravenous immunoglobulins are used as first-line drugs. Second-line drugs include thrombopoietin receptor agonists. Chronic therapy includes the administration of an agonist for the thrombopoietin receptor, in immunosuppressed patients then azathioprine, 6-mercaptopurine, sirolimus, ciclosporin or mycophenolate mofetil, In the last case, we can use rituximab, or splenectomy is performed.

Keywords: immune thrombocytopenia, children, petechial rush, rituximab.

Accepted: October 4, 2022; Published: October 11, 2022  Show citation