Acute autoimmune thrombocytopenia

Childhood acute autoimmune thrombocytopenia is defined as a bleeding disord er in otherwise healthy children caused by transient destruction of platele ts. It is benign, presenting mostly with skin purpura and minor bleeds. The diagnosis requires information about previous infections or immunizations, a physical examination looking for signs or symptoms for other causes of t hrombocytopenia and a complete blood count with examination of the peripher al blood smear focusing on the number and morphology of platelets. Bone mar row examination is indicated only when in doubt and should be considered if prednisone therapy is planned. A threshold platelet count dividing high- a nd low-risk groups in immune thrombocytopenia (ITP) is not known because of problems with platelet counting in thrombocytopenia and the lack of clinic al data. Immunoglobulins or glucocorticoids increase the platelet count, pr obably by blockage of the phagocytic monocyte-macrophage system. However, i t is unclear whether this increase influences bleeding or mortality or whet her the disadvantages of these medications might outweigh their benefits.