The nontreatment of childhood ITP (or "The art of medicine consists of amusing the patient until nature cures the disease")

The management of childhood acute idiopathic thrombocytopenic purpura is co ntroversial, with recent guidelines highlighting the lack of suitable evide nce upon which. to base management decisions. Three European centers have u sed an expectant policy and results over the past decade demonstrate that t his is safe and convenient for the majority of children. Adequate parental education about the condition from an experienced specialist is essential, together with open access for children should they develop any problems. A clinical stratification of such patients must be incorporated into any futu re trials, together with quality of life assessment to discover the impact of restrictions on lifestyle, particularly in adolescents with chronic ITP who may need a different approach.