Thrombocytopenia in children
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Pediatric thrombocytopenia is when there are insufficient normal platelets in the blood. Platelets are the blood component that stop bleeding and assist in blood clotting.
A child with thrombocytopenia may bleed more easily, including bruise more quickly, bleed from mucosal surfaces (nosebleeds, mouth bleeds, intestinal bleeding, urine bleeding, and/or heavy menstrual periods), and occasionally into organs.
The most frequent causes of thrombocytopenia in children are infections, particularly viral infections, and the immune system’s destruction of platelets (referred to as immunological thrombocytopenia, or ITP). Depending on the underlying cause, children with thrombocytopenia may also have decreased levels of other blood cell types, such as red and white blood cells.
Hemorrhaging excessively can be harmful and have an impact on the brain or crucial bodily processes.
Symptoms
The signs and symptoms of a child with a slightly low platelet count could not be present. The following issues could arise for children if the count falls low enough:
- Easily bruise
- Heavy bleeding from small wounds
- Heavy nosebleeds
- Bleeding gums
- Prolonged bleeding following dental work
- Heavy menstrual bleeding
- Petechiae, or little red or purple patches on the skin
- Purpura, a purple spots that resemble to bruises
- Blood in vomit, urine, or stool
Bleeding in the brain is the most dangerous sort of bleeding that can occur. Although bleeding in or around the brain cannot be seen, it can cause headaches or alter thinking or behavior.
Any serious bleeding that won’t stop after applying pressure to the area should be treated by a healthcare provider immediately.
Causes
Thrombocytopenia typically results from an underlying condition. There are two causes of thrombocytopenia:
- Bone marrow production: There are not enough platelets produced in the bone marrow, which also produces all other blood cells. Bone marrow failure syndromes or leukemia can be underlying illnesses contributing to this condition. Additionally, some medications, such as those used in chemotherapy, can prevent the bone marrow from producing enough platelets.
- Platelet destruction: In the spleen or circulation, platelets are destroyed more quickly than usual. Hypersplenism, immune thrombocytopenia, thrombotic thrombocytopenic purpura, a few autoimmune diseases, or a blood infection with bacteria can all contribute to this condition. Mild thrombocytopenia can also be brought on by pregnancy.
Several factors can lead to thrombocytopenia. Some of them are really serious and demand medical care. Others are not significant and might go away by themselves over time.
Diagnosis
When a child experiences frequent bleeding, bruising, or red spots on the skin, a healthcare professional may consider thrombocytopenia.
- Physical examination: Healthcare provider will conduct thorough physical examination and medical history.
- Blood test: A complete blood count (CBC) test will be ordered by the healthcare provider.
- Biopsy: To get a sample of bone marrow for testing and examination under a microscope, the healthcare provider will request a biopsy.
Additional testing is carried out to determine the cause of thrombocytopenia if it is diagnosed. The necessary tests are determined by the child’s medical history, the findings of the exam, and the results of the blood test.
Treatment
In some cases, especially when triggered by pregnancy, mild thrombocytopenia may not even need treatment. Usually, after giving delivery, pregnancy-related symptoms disappear. However, some types require medical attention to both increase platelet count to a safe level and address the underlying cause.
Whether or not there is bleeding, how low the platelet count is, or what is causing the thrombocytopenia will all affect how it is treated. Treatment options for severe thrombocytopenia may include:
- Underlying condition: Thrombocytopenia may go away on its own if the underlying cause is treated. For instance, if a medication side effect is responsible for the low platelet count, discontinuing the medication could resolve the issue.
- Blood transfusion: New platelets are added to replace lost ones. The patient receives these donated platelets through a vein.
- Steroid or immunoglobulin treatment: If an autoimmune reaction is the cause of thrombocytopenia, the doctor may recommend medications to block the antibodies from attacking the platelets.
- Surgery: If the spleen is retaining too many platelets and preventing them from moving through the bloodstream, spleen removal (splenectomy) treatment may be necessary in rare circumstances.
Hematologists, healthcare providers who focus on identifying and treating blood diseases, are typically the ones who treat thrombocytopenia.
