Thrombocytopenia in children: What to know

Thrombocytopenia occurs when there are not enough blood platelets in the body. This might cause easy bruising and heavy bleeding.

Acute immune thrombocytopenia (ITP) is rather frequent in children, and it can develop after a viral disease like chickenpox. In certain circumstances, the condition lasts a long time. It could be the result of pharmaceutical use or a genetic abnormality.

A kid with acute ITP normally recovers in 6 months, and if the condition is moderate, no therapy is required.

Learn more about thrombocytopenia in children in the sections below.

Symptoms

Patches of bruises or purple areas of skin are one of the most obvious indicators.

Other signs and symptoms include:

  • blood blisters in mouth
  • blood in urine
  • heavy menstrual bleeding, in adolescents
  • tiny red, rash-like spots
  • bleeding freely
  • bruising easily

Types and causes

thrombocytopenia in children

Many reasons might cause a low blood platelet count.

Acute ITP

Researchers believe that viruses like the one that causes chickenpox can cause a child’s immune system to malfunction and attack platelets, resulting in acute ITP.

This problem is more common in children aged 2 to 6. Symptoms are usually modest and go away on their own after 6 months. However, one out of every five children with the condition develops chronic ITP.

Chronic ITP

This is uncommon in young children, but it is more common in teenagers and adults, especially women. It can persist for months or perhaps a lifetime, and it necessitates specialized care. Chronic ITP appears to resolve in some people, although it recurs frequently.

Drug-induced thrombocytopenia

In infants and other young children, thrombocytopenia can develop as a result of medicine, and this can be life threatening.

A baby’s platelet count dropped dramatically after getting ranitidine (Zantac) for difficulty feeding, according to a case report and analysis published in 2019. Acid reflux can also be treated with ranitidine.

More research is needed to fully understand the effects of ranitidine and comparable medicines on platelet count in newborns and young children.

Infections

Several viral illnesses can cause secondary thrombocytopenia by lowering platelet counts. HIV, dengue fever, and malaria are only a few of these diseases.

Malaria, in particular, can cause a significant decline in a child’s platelet levels, according to a study published in 2021. The authors speculate that the presence of thrombocytopenia in children could be a good indicator of malaria.

MYH9-related thrombocytopenia

The low platelet count is caused by a genetic mutation rather than the immune system targeting the body’s platelets in this type of thrombocytopenia.

The MYH9 gene is in charge of producing proteins found in some blood cells, such as platelets. This mutation can be inherited from one’s parents or developed spontaneously.

A MYH9 gene mutation can cause thrombocytopenia in a variety of diseases:

  • May-Hegglin anomaly
  • Epstein syndrome
  • Sebastian syndrome
  • Fechtner syndrome

Aplastic anemia

Thrombocytopenia can be caused by aplastic anemia, which is a type of bone marrow failure. The bone marrow generates less red and white blood cells, as well as platelets, when it shuts down.

Aplastic anemia most often develops without apparent cause, which clinicians refer to as “idiopathic” aplastic anemia. Some children, however, may be born with the condition or develop it as a result of an infection.

Bone marrow failure usually strikes children between the ages of one and five, or between the ages of twelve and twenty.

Cause and diagnosis

Doctors assess a person’s medical history, as well as the findings of a physical examination and testing, when diagnosing thrombocytopenia and determining its cause, according to the National Heart, Lung, and Blood Institute.

Previous medical history

A doctor may inquire about anything that could have an impact on platelet levels, such as:

  • any relatives with a low platelet count or other associated disorders
  • the use of prescription and over-the-counter medicines
  • general eating habits

Examination of the body

During this time, the doctor examines the patient for symptoms of bruises or bleeding. They may also look for infection symptoms, such as a temperature.

Diagnostic tests

If a doctor detects thrombocytopenia, they will do a series of tests to establish the cause of the problem.

These tests may involve the following:

  • Bone marrow tests: This confirms bone marrow health.
  • Prothrombin time test: This measures the blood clotting rate in seconds.
  • A complete blood count: The results can confirm low platelet levels.
  • A blood smear: This shows whether the platelets appear healthy.

Treatments

The treatment for thrombocytopenia in children is determined on the cause and severity of the symptoms.

A child with mild acute ITP, for example, is unlikely to require therapy because the condition usually resolves on its own. A blood or platelet transfusion may be required if the youngster is highly prone to hemorrhage profusely.

A child with persistent ITP that recurs regularly may require immune-suppressing medicine, such as rituximab. If the cause is an infectious disease, such as HIV, the doctor may prescribe corticosteroids, which reduce platelet degradation.

The overall goal of thrombocytopenia therapy is to avoid significant consequences. If the low platelet count is caused by an underlying health condition, the doctor will address both problems.

Conclusion

Low platelet numbers in the blood cause thrombocytopenia, which increases the risk of bleeding and bruising.

The most frequent type of thrombocytopenia in children is acute ITP, which normally goes away on its own within 6 months. Medication, infections, and a genetic mutation are also less common causes of thrombocytopenia.

If a child’s symptoms are minor, treatment may not be necessary. A child with persistent ITP may require immunosuppressive medicine due to the danger of serious bleeding.

Sources:

  • https://www.scirp.org/journal/paperinformation.aspx?paperid=106690
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6397013/
  • https://www.seattlechildrens.org/conditions/itp/
  • https://www.medicalnewstoday.com/articles/thrombocytopenia-in-children
  • https://www.nhlbi.nih.gov/health-topics/immune-thrombocytopenia
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6056371/
  • https://beta.rarediseases.info.nih.gov/diseases/180/myh9-related-thrombocytopenia
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5970098/
  • https://www.nhlbi.nih.gov/health-topics/thrombocytopenia

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