Idiopathic thrombocytopenic purpura in children

July 2017
On this page you will find some of the recommendations of expert paediatricians on Idiopathic thrombocytopenic purpura of the child. The purposes of these recommendations are to improve the quality of life of the children and to avoid over-medication.


Current state of affairs

Reminder




Idiopathic thrombocytopenic purpura:
  • It is an illness characterised by a thrombocytopenia (a loss in the number of blood platelets) associated with the presence of antibodies at the platelet surface,
  • It is often associated with a risk of over-estimated severe hemorrhage that leads to over-medication.

Monitoring and Prevention

  • Clinical monitoring
    • Parents and attending physicians must learn how to locate hemorrhages,
    • Control platelet numeration:
      • In case of hemorrhagic symptoms or of aggravation of a clinical hemorrhagic syndrome,
      • As a reaction to a new treatment,
      • Situation where the risk of hemorrhage is high: hemorrhagic event, intervention...
  • Prevention and management of the mucous hemorrhages
    • Oral hygiene
      • Use of a flexible toothbrush,
      • Mouthwashes.
    • Epistaxis
      • Local treatment,
      • Cauterisation of the wound.
    • Menorrhagia
      • Evaluation of the abundance of the periods,
      • In case of strong bleedings, to recommend a gynaecological consultation.

Risques and recommendations

To avoid or control

  • Aspirine and ibuprofen,
  • Rectal temperature measuring ,
  • Intramuscular gestures,
  • For hemorrhagic risk procedures:
    • Lumbar puncture: to have at least 50.000 platelets,
    • To carry out the procedure in an institution which can transfuse blood platelets,
    • To support the procedure which allow a local haemostasis,
    • A corticoid treatment can be associated with the procedure according to its importance and to the duration because of the hemorrhagic risk.
  • Surgical operations
    • Realisable when a careful surgical haemostasis is possible,
    • Same precautions as for the hemorrhagic risk procedures.
  • Authorised procedures associated with local hemostatic measures:
    • Bone marrow examination,
    • Subcutaneous, intravenous injections and stitches,
    • Arterial puncture of the radial artery.
  • Vaccinations
    • Temporarily contra-indicated (aggravation of the autoimmunity),
    • Possible after 1 year of cure.

Advice concerning the framework of life of the child


Recommendations:
  • Continuation of schooling,
  • Systematic contact with the school doctor,
  • To support:
    • Out-of-schools activities,
    • Continuation of sports and physical education training with some changes
      • Possible swimming but no scuba-diving and apnea,
      • Use of adapted protections,
      • Traumatic sports are not recommended: rugby, martial arts...
      • Supervised sports practice:
        • Information for teachers,
        • Doctor's certificate of hematologic absence of counterindications to do sports.
  • Concerning travels:
    • No contraindications to travel,
    • No recommended stays in countries with low medical capabilities,
    • In all the cases, the child must have on him:
      • Medical notes specifying the history of the disease,
      • Contacts for a doctor,
      • Blood group card.

Sources


Photographic copyright: Valua Vitaly - Fotolia.com

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Latest update on April 11, 2010 at 03:04 PM by owliance.en_ctrl_002.
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