Acute immune thrombocytopenia (ITP) in children is a benign disease, presen
ting mostly with skin purpura and minor bleeds. It has a high rate of spont
aneous remission. Intracranial hemorrhage (ICH) is extremely rare; the risk
is higher during the chronic phase and in children with additional risk fa
ctors, The threshold platelet count in ITP is not known because of problems
with platelet counting in thrombocytopenia and the lack of clinical data.
The threshold is probably lower than in leukemia, because primary hemostasi
s is better in ITP, So far, there is no proof for the clinical efficacy of
treatment or prophylaxis with intravenous immunoglobulin (IVIg) and glucoco
rticoids (GC), medications that have several adverse effects. The question
remains open whether or not we are treating the platelet count in children
with acute ITP.