Management of chronic idiopathic thrombocytopenic purpura in childhood: a dilemma

ABSTRACT

Chronic ITP in children is generally a benign condition but its management is fraught with worry and controversy. Numerous reviews and the large number of therapeutic approaches attest to the uncertainty about the most effective and safe treatment modality and highlights the lack of knowledge about its natural history. Few patients develop serious complications or long term sequel. Steroids or IVIg may benefit some patients who suffer form clinical bleeding. Before resorting to splenectomy in severe resistant cases it may be worthy to try a course of pulsed high dose dexamethasone therapy. The decision to treat a child with chronic ITP should be individualized according to the clinical condition rather than the platelet count alone