WHAT ARE SOME SYMPTOMS OF ITP? • Bruising, especially if the bruises cannot be explained by injuries, they are located in uncommon places (like the head or chest), or more bruises exist than are expected. • Petechiae (flat, pinpoint-sized red or purple dots) caused by minor bleeding appear under the skin.
• Nose bleeds and mouth bleeding from gums occur. • Heavy menstrual bleeding (heavy periods) occurs. • Blood appears in urine or stool.
• Confusion, seizures, weakness, or loss of consciousness occur. In rare cases, these symptoms may indi - cate intracranial (brain) hemorrhage or other internal bleeding (for example, in the stomach or lungs).
HOW IS ITP DIAGNOSED? Most children are diagnosed with ITP when their platelet count drops very low and they develop symptoms. To diagnose ITP, your healthcare provider will draw a sample of blood from your child to check the number of platelets. A low platelet count (less than 100,000) but a normal number of other blood cells (red cells and white cells) will usually indicate ITP. Your healthcare provider may ask questions about medications that your child is taking and about recent infections, vaccinations, or immune disorders that may be affecting your child. The healthcare pro - vider will also examine your child for signs of a low platelet count (bruising or petechiae) or infection (enlarged lymph nodes, liver, or spleen). The healthcare provider may also do blood tests to determine if antibodies are being made against the platelets or if there is a higher than normal percentage of immature (young) platelets in the blood. Low platelet counts may also be found in children with other conditions that affect the bone marrow. For this reason, the healthcare provider may ask to do a bone marrow aspiration and biopsy. This test will show whether the platelets are still being made as expected and whether any abnormal cells in the bone marrow are causing your child’s symptoms. During a bone marrow aspiration and biopsy, a needle is inserted into the marrow inside the bone. Some of the marrow (biopsy) and the fluid in the marrow (aspirate) are collected. Patients undergoing bone marrow aspirations and biopsies may experience pain, so children often are sedated for this procedure. If your child is uncomfortable after the test, a mild pain medication such as acetaminophen (Tylenol®) may be given, but not ibuprofen (Motrin® or Advil®) or aspirin.
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