Thrombocytopenia in children

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.