Idiopathic thrombocytopenia purpura (ITP)IIdiopathic thrombocytopenia purpura (ITP)Idiopathic thrombocytopenia purpura (ITP)EnglishHaematologyChild (0-12 years);Teen (13-18 years)BodyCardiovascular systemConditions and diseasesCaregivers Adult (19+)NA2011-06-02T04:00:00ZMelanie Kirby-Allen, MD, FRCPC9.0000000000000053.00000000000001618.00000000000Health (A-Z) - ConditionsHealth A-Z<p>A general overview or idiopathic thrombocytopenia purpura or ITP, an acquired blood disorder.</p><h2>What is ITP?</h2> <p>Idiopathic thrombocytopenia purpura (ITP) is an acquired disorder, resulting from an increase in the breakdown of platelets. ITP is not a cancer or malignancy. Platelets are small blood cells needed for normal blood clotting. In healthy people, old platelets are destroyed in the spleen by a type of white cell called a macrophage. With ITP, this process is much more rapid. Acute ITP occurs more frequently in children between the ages of two and nine, although it can occur in children of any age. ITP is found equally in boys and girls.</p><h2>Key points</h2> <ul> <li>Idiopathic thrombocytopenia purpura (ITP) is an acquired disorder. ITP is not a cancer or malignancy.</li> <li>Platelets, or thrombocytes, are blood cells produced in the bone marrow. Platelets circulate in the blood for approximately eight to 10 days.</li> <li>The most common sign of ITP is the appearance of numerous pinpoint haemorrhages, or petechiae, which look like tiny red spots under the skin.</li> <li>About 80% to 90% of patients recover spontaneously, usually within three months from the beginning of the illness.</li> <li>ITP can be treated in several ways: prednisone, intravenous immunoglobulin, intravenous Anti-D and splenectomy (removal of the spleen).</li> <li>Always check with your child's doctor before giving them any medication. Acetylsalicylic acid (ASA) or any medication that contains ASA should be avoided.</li> </ul><h2>Signs and symptoms of ITP</h2> <p>The most common sign of ITP is the appearance of numerous pinpoint haemorrhages, or petechiae, which look like tiny red spots under the skin. The presence of petechiae along with bruising is referred to as purpura. Both are caused by spontaneous bleeding in the skin and mucous membranes (surfaces in the skin and mouth). Except for signs of bleeding, your child may appear well.</p><h2>Causes of ITP</h2> <p>The onset of ITP is generally sudden. Most cases occur a few days or even weeks after a viral infection, such as chicken pox or a respiratory infection. Sometimes ITP can be caused by an unusual response in the body to a drug. Researchers think that antibodies formed naturally by the body's immune system attach themselves to the platelets. The platelets are then rapidly destroyed. If the body is unable to produce enough new platelets to replace those destroyed by the antibodies, the number of platelets in the blood will decrease.</p><h2>Diagnosing ITP</h2> <p>The doctor will take a careful history of your child's past health and current illness. If your child's doctor suspects ITP, a physical examination will be performed and a blood test will be ordered. Blood will be taken either by a finger prick or from a vein in the arm. The results of the physical examination and blood test will help confirm the diagnosis of ITP. In most cases, a sample of bone marrow will also be taken to rule out other causes of a low platelet count.</p> <p>Once ITP has been diagnosed, a daily blood test is usually ordered to assess the number of platelets in the blood.</p><h2>Treatment of ITP</h2><p>ITP can be treated in several ways. Your child's doctor will advise you on whether treatment is necessary. Treatment is the same for both acute and chronic ITP. The following treatments are most common:</p><h3>Prednisone</h3><p>Prednisone is a steroid. It is given in pill form and taken by mouth.</p><h3>Intravenous immunoglobulin</h3><p>This is a protein solution prepared from the plasma of many blood donors. This solution is given by infusion into a vein over several hours. It works by temporarily preventing platelet destruction in the spleen. The spleen is the body organ responsible for the rapid destruction of the platelets.</p><h3>Intravenous Anti-D</h3><p>Like <a href="/Article?contentid=161&language=English">intravenous immunoglobulin</a>, Anti-D is a protein solution prepared from blood plasma. The solution is given by infusion into a vein over a 20 to 30 minute period. It also works by temporarily preventing platelet destruction in the spleen.</p><h3>Splenectomy</h3><p>If ITP does not respond to medical treatment, or the side effects of the treatment are too severe, a splenectomy may be required. A splenectomy is the removal of the spleen by a surgical procedure. </p><p>Following treatment, the platelet count should rise. The petechiae and bruising will begin to disappear. Your child's doctor will probably want a few blood tests done, at regular intervals, to assess the platelet counts.</p><p>Medical treatment does not actually cure ITP. Instead, it raises the platelet count for a period ranging anywhere from a few weeks to even months. If your child's ITP does not clear up spontaneously during this time, the platelet count will fall again. More therapy will be required until the ITP disappears spontaneously.</p><h2>Side effects of medication</h2><h3>Prednisone</h3><p>The most common side effect is weight gain due to increased appetite. It is characterized by a "moon face," "pot belly" and fat deposits on the back of the shoulders. These symptoms are temporary and will disappear when the drug is stopped.</p><p>Other side effects associated with prednisone include:</p><ul><li>acne</li><li>increased blood pressure</li><li>a change in the level of blood sugar</li><li>mood swings ranging from euphoria to temper tantrums</li></ul><p>If your child is taking prednisone and comes into contact with chicken pox, seek medical attention right away. Your child's doctor may want to change the type of treatment.</p><h3>Intravenous immunoglobulin</h3><p>The most common side effects are headaches, fever, and nausea. In most cases, these side effects occur when two treatments are given back-to-back (12 hours apart). Give your child <a href="/Article?contentid=62&language=English">acetaminophen</a> to relieve their headache and/or fever. Similarly, give your child dimenhydrinate to treat nausea and vomiting. Within 24 hours after the second dose of <a href="/Article?contentid=161&language=English">intravenous immunoglobulin</a>, the symptoms should disappear. If only a single dose of intravenous immunoglobulin is given, the chance of these side effects occurring is small.</p><h3>Intravenous Anti-D</h3><p>The most serious side effect is a drop in the level of haemoglobin (red cells) in the blood. The biggest drop will occur seven to 10 days after the Anti-D has been given. Your child may appear tired and pale. In most cases, the haemoglobin does not drop low enough to require a transfusion.</p><h2>Medications to avoid</h2><p>If your child has ITP, always check with their doctor before giving them any medication. <a href="/Article?contentid=77&language=English">Acetylsalicylic acid</a> (ASA) or any medication that contains ASA should be avoided. This is because ASA interferes with platelet function for a period of seven to 10 days. If your child has a low platelet count, this may increase their risk of bleeding. All over-the-counter cough and cold medications should be carefully checked before being bought. If you are unsure if a medicine contains ASA or not, check with your pharmacist.</p><p>The following is a short list of medicines that should not be given to your child with ITP:</p><ul><li>ASA and all compounds that contain it</li><li>antihistamines</li><li>non-steroidal anti-inflammatory drugs (NSAIDs)</li><li>vitamin E</li><li>cod liver oil</li></ul>
Purpura thrombopénique idiopathique (PTI)PPurpura thrombopénique idiopathique (PTI)Idiopathic thrombocytopenia purpura (ITP)FrenchHaematologyChild (0-12 years);Teen (13-18 years)BodyCardiovascular systemConditions and diseasesCaregivers Adult (19+)NA2011-06-02T04:00:00ZMelanie Kirby-Allen, MD, FRCPC9.0000000000000053.00000000000001618.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Cette brochure vise à fournir des renseignements généraux sur le PTI aux parents et aux enfants. </p><h2>Qu’est-ce que le PTI? </h2> <p>Le Purpura thrombopénique idiopathique (PTI) est un trouble acquis, découlant d’une augmentation de la décomposition de plaquettes. Le PTI n’est pas un cancer ou une malignité. Les plaquettes sont des petits globules blancs nécessaires pour la coagulation sanguine normale. Chez les personnes en santé, les vieilles plaquettes sont détruites dans la rate par un type de cellule blanche appelée un macrophage. Dans le cas du PTI, ce processus est beaucoup plus rapide. Le PTI aigu se produit plus fréquemment chez des enfants âgés de 2 à 9 ans, bien qu’il puisse se produire chez des enfants de tout âge. Le PTI se retrouve dans la même mesure chez des garçons et des filles. </p><h2>À​ retenir</h2> <ul> <li>Le purpura thrombopénique idiopathique (PTI) est un trouble acquis. Le PTI n’est pas un cancer ou une malignité (tumeur maligne).</li> <li>Les plaquettes, ou les thrombocytes, sont des cellules sanguines produites dans la moelle osseuse. Les plaquettes circulent dans le sang pendant environ 8 à 10 jours.</li> <li>Le signe le plus courant du PTI est l’apparence de nombreux micro hémorragies, appelées des pétéchies, qui ont l’apparence des petites taches rougeâtres [sur] la peau.</li> <li>Environ 80 à 90% des patients se remettent d’une manière spontanée, normalement dans les trois mois suivant le commencement de la maladie.</li> <li>Le PTI peut être traité de plusieurs façons : prednisone, immunoglobuline intraveineuse, Anti-D intraveineuse, et la splénectomie (enlèvement de la rate).</li> <li>Vérifiez toujours auprès de son médecin avant d’administrer un médicament. L’Acide acétylsalicylique (ASA, AspirinMD) ou tout médicament contenant de l’aspirine doit être évité. </li> </ul><h2>Signes et symptômes du PTI </h2> <p>Le signe le plus courant du PTI est l’apparence de nombreux micro hémorragies, appelées des pétéchies, qui ont l’apparence des petites tâches rougeâtres sur la peau. La présence des pétéchies accompagnées des ecchymoses s’appelle le purpura. Les deux sont causés par le saignement spontané dans la peau et des muqueuses (surfaces dans la peau et la bouche). À l’exception des signes de saignement, votre enfant semblera aller bien. </p><h2>Causes du PTI </h2> <p>En général, le PTI commence d’une manière brusque. La plupart des cas se produisent quelques jours ou même semaines suivant une infection virale, tel que la varicelle ou une infection respiratoire. Parfois le PTI peut être causé par une réponse inhabituelle dans le corps à un médicament. Des chercheurs estiment que les anticorps formés naturellement par le système immunitaire de corps s’attachent aux plaquettes. Par la suite, les plaquettes sont détruites rapidement. Si le corps n’est pas en mesure de produire suffisamment de nouvelles plaquettes pour remplacer celles qui ont été détruites par les anticorps, cela entraînera une diminution du nombre de plaquettes dans le sang. </p><h2>Diagnostic du PTI </h2> <p>Le médecin recueillera soigneusement les antécédents médicaux ainsi que les affections actuelles de votre enfant. Si le médecin de votre enfant soupçonne l’incidence du PTI, il réalisera un examen physique et vous demandera de faire effectuer une analyse de sang. La prise de sang sera effectuée soit au moyen d’une piqûre sur le doigt soit à partir d’une veine dans le bras. Les résultats de l’examen physique et de l’analyse de sang serviront à confirmer le diagnostic du PTI. Dans la plupart des cas, une prise d’un échantillon de la moelle osseuse sera également effectuée afin d’exclure d’autres cas d’une numération plaquettaire basse.</p> <p>Dès le diagnostic du PTI, on demande normalement une analyse de sang quotidienne afin de surveiller la numération plaquettaire. </p><h2>Traitement du PTI </h2><p>Il existe plusieurs façons de traiter le PTI. Le médecin de votre enfant prendra la décision concernant le traitement à adopter. Le traitement reste le même pour le PTI aigu ainsi que pour le PTI chronique. Les traitements les plus courants sont les suivants : </p><h3>Prednisone</h3><p>La prednisone est un stéroïde. Il est administré sous forme d’un comprimé et par voie orale.</p><h3>Immunoglobuline intraveineuse </h3><p>C’est une solution protéique préparée à partir du plasma de plusieurs donneurs de sang. Cette solution est administrée par infusion dans la veine sur plusieurs heures. Il fonctionne par empêcher temporairement la destruction plaquettaire dans la rate. La rate est l’organe du corps responsable de la destruction rapide des plaquettes. </p><h3>Anti-D intraveineuse </h3><p>Tout comme <a href="/Article?contentid=161&language=French">l’immunoglobuline intraveineuse</a>, l’anti-D est une solution protéique préparée à partir du plasma sanguin. Cette solution est administrée par infusion dans la veine pendant une période de 20 à 30 minutes. Il fonctionne par l’empêchement temporaire de la destruction plaquettaire dans la rate. </p><h3>Splénectomie </h3><p>Si le PTI ne réagit pas au traitement médical, ou que les effets secondaires du traitement sont trop sévères, une splénectomie pourrait être exigé. La splénectomie s’agit de l’enlèvement de la rate par intervention chirurgicale. </p><p>Suivant le traitement, la numération plaquettaire devrait augmenter. Les pétéchies et l’ecchymose commenceront à disparaître. Il se peut que le médecin de votre enfant vous demande de faire faire quelques analyses de sang, à intervalles réguliers, afin d’évaluer la numération plaquettaire. </p><p>Le traitement médical n’a pas l’objectif de guérir votre enfant du PTI. Plutôt, il augmente la numération plaquettaire pour une période durant de quelques semaines à même plusieurs mois. Si le PTI de votre enfant n’est pas résolu spontanément durant ce temps, la numération plaquettaire chutera de nouveau. Une telle situation exigera plus de traitement jusqu’à ce que le PTI disparaisse complètement. </p><h2>Effets secondaires des médicaments </h2><h3>Prednisone</h3><p>L’effet secondaire le plus courant est la prise de poids en raison d’une hausse de l’appétit. Il est caractérisé par un visage rond, une bedaine, et des dépôts de graisse en arrière des épaules. Ces symptômes sont temporaires et disparaîtront dès l’arrêt du médicament.</p><p>D’autres effets secondaires liés à la prednisone comprennent:</p><ul><li>l’acné </li><li>une hausse de la pression artérielle </li><li>un changement du niveau de glycémie </li><li>changements d’humeur allant de l’euphorie aux crises de colère </li></ul><p>Si votre enfant entre en contact avec la varicelle pendant qu’il suit le traitement de la prednisone, obtenez de l’aide médicale immédiatement. Le médecin de votre enfant peut élire de suivre autres pistes de traitement. </p><h3>Immunoglobuline intraveineuse </h3><p>Les effets secondaires les plus courants sont des maux de tête (céphalées), la fièvre et la nausée. Dans la plupart des cas, ces effets secondaires surviennent lorsque 2 traitements sont administrés de suite (intervalle de 12 heures). Donnez de <a href="/Article?contentid=62&language=French">l’acétaminophène</a> à votre enfant pour le soulagement de la douleur et/ou de la fièvre. De même, donnez du dimenhydrinate (GravolMD) pour traiter les nausées et les vomissements. Les symptômes devraient disparaître dans les 24 heures suivant la deuxième dose de <a href="/Article?contentid=161&language=French">l’immunoglobuline intraveineuse</a>. Si un seul traitement d’immunoglobuline intraveineuse a été administrée, la probabilité de l’apparition de ces effets secondaires est peu importante. </p><h3>Anti-D intraveineuse </h3><p>L’effet secondaire le plus grave est une baisse du taux d’hémoglobine (globules rouges) dans le sang. La chute la plus importante surviendra 7 ou 10 jours après l’administration de l’anti-D. Votre enfant aura l’air fatigué et pâle. Dans la plupart des cas, la chute de l’hémoglobine n’est pas suffisamment importante pour nécessiter une transfusion.</p><h2>Médicaments à éviter </h2><p>Si votre enfant est atteint du PTI, vérifiez toujours auprès de son médecin avant d’administrer un médicament. <a href="/Article?contentid=77&language=French">L’acide acétylsalicylique</a> ou tout médicament contenant de l’aspirine doit être évité. L’acide acétylsalicylique entrave la fonction plaquettaire pendant une période de 7 à 10 jours. Si votre enfant a une numération plaquettaire basse, ceci pourrait augmenter le risque de saignement. Tout médicament en vente libre pour la toux et le rhume doit être soigneusement vérifié avant l’achat. En cas de doute concernant la présence de l’aspirine dans un médicament, consulter votre pharmacien.</p><p>Voici une liste nullement limitative des médicaments que vous ne devez pas donner à votre enfant qui est atteint du PTI : </p><ul><li>l’acide acétylsalicylique et tous les composés contenant l’aspirine</li><li>les antihistaminiques</li><li>les anti­inflammatoires non stéroïdiens (AINS)</li><li>la vitamine E</li><li>huile de foie de morue </li></ul>

 

 

Idiopathic thrombocytopenia purpura (ITP)842.000000000000Idiopathic thrombocytopenia purpura (ITP)Idiopathic thrombocytopenia purpura (ITP)IEnglishHaematologyChild (0-12 years);Teen (13-18 years)BodyCardiovascular systemConditions and diseasesCaregivers Adult (19+)NA2011-06-02T04:00:00ZMelanie Kirby-Allen, MD, FRCPC9.0000000000000053.00000000000001618.00000000000Health (A-Z) - ConditionsHealth A-Z<p>A general overview or idiopathic thrombocytopenia purpura or ITP, an acquired blood disorder.</p><h2>What is ITP?</h2> <p>Idiopathic thrombocytopenia purpura (ITP) is an acquired disorder, resulting from an increase in the breakdown of platelets. ITP is not a cancer or malignancy. Platelets are small blood cells needed for normal blood clotting. In healthy people, old platelets are destroyed in the spleen by a type of white cell called a macrophage. With ITP, this process is much more rapid. Acute ITP occurs more frequently in children between the ages of two and nine, although it can occur in children of any age. ITP is found equally in boys and girls.</p><h2>How platelets work</h2> <p>Platelets, or thrombocytes, are blood cells produced in the bone marrow. Platelets circulate in the blood for approximately eight to 10 days. At any given time, about two-thirds of all platelets are present in the blood stream while one-third remain in the spleen. New platelets are always being made in the bone marrow.</p> <p>The main function of platelets is to prevent bleeding. A normal platelet count ranges from 150,000 to 400,000 per microlitre of blood. A microlitre is a unit of volume equal to one-millionth of a litre.</p> <p>If your child has a low platelet count, they may bruise easily and bleed from superficial surfaces. For example, they may get nosebleeds. If your child's platelet count is less than 50,000 per microlitre, they will bruise more easily than normal. If your child's platelet count is less than 20,000 per microlitre, they may develop spontaneous bleeding.</p><h2>Key points</h2> <ul> <li>Idiopathic thrombocytopenia purpura (ITP) is an acquired disorder. ITP is not a cancer or malignancy.</li> <li>Platelets, or thrombocytes, are blood cells produced in the bone marrow. Platelets circulate in the blood for approximately eight to 10 days.</li> <li>The most common sign of ITP is the appearance of numerous pinpoint haemorrhages, or petechiae, which look like tiny red spots under the skin.</li> <li>About 80% to 90% of patients recover spontaneously, usually within three months from the beginning of the illness.</li> <li>ITP can be treated in several ways: prednisone, intravenous immunoglobulin, intravenous Anti-D and splenectomy (removal of the spleen).</li> <li>Always check with your child's doctor before giving them any medication. Acetylsalicylic acid (ASA) or any medication that contains ASA should be avoided.</li> </ul><h2>Signs and symptoms of ITP</h2> <p>The most common sign of ITP is the appearance of numerous pinpoint haemorrhages, or petechiae, which look like tiny red spots under the skin. The presence of petechiae along with bruising is referred to as purpura. Both are caused by spontaneous bleeding in the skin and mucous membranes (surfaces in the skin and mouth). Except for signs of bleeding, your child may appear well.</p><h2>Causes of ITP</h2> <p>The onset of ITP is generally sudden. Most cases occur a few days or even weeks after a viral infection, such as chicken pox or a respiratory infection. Sometimes ITP can be caused by an unusual response in the body to a drug. Researchers think that antibodies formed naturally by the body's immune system attach themselves to the platelets. The platelets are then rapidly destroyed. If the body is unable to produce enough new platelets to replace those destroyed by the antibodies, the number of platelets in the blood will decrease.</p><h2>Diagnosing ITP</h2> <p>The doctor will take a careful history of your child's past health and current illness. If your child's doctor suspects ITP, a physical examination will be performed and a blood test will be ordered. Blood will be taken either by a finger prick or from a vein in the arm. The results of the physical examination and blood test will help confirm the diagnosis of ITP. In most cases, a sample of bone marrow will also be taken to rule out other causes of a low platelet count.</p> <p>Once ITP has been diagnosed, a daily blood test is usually ordered to assess the number of platelets in the blood.</p><h2>Treatment of ITP</h2><p>ITP can be treated in several ways. Your child's doctor will advise you on whether treatment is necessary. Treatment is the same for both acute and chronic ITP. The following treatments are most common:</p><h3>Prednisone</h3><p>Prednisone is a steroid. It is given in pill form and taken by mouth.</p><h3>Intravenous immunoglobulin</h3><p>This is a protein solution prepared from the plasma of many blood donors. This solution is given by infusion into a vein over several hours. It works by temporarily preventing platelet destruction in the spleen. The spleen is the body organ responsible for the rapid destruction of the platelets.</p><h3>Intravenous Anti-D</h3><p>Like <a href="/Article?contentid=161&language=English">intravenous immunoglobulin</a>, Anti-D is a protein solution prepared from blood plasma. The solution is given by infusion into a vein over a 20 to 30 minute period. It also works by temporarily preventing platelet destruction in the spleen.</p><h3>Splenectomy</h3><p>If ITP does not respond to medical treatment, or the side effects of the treatment are too severe, a splenectomy may be required. A splenectomy is the removal of the spleen by a surgical procedure. </p><p>Following treatment, the platelet count should rise. The petechiae and bruising will begin to disappear. Your child's doctor will probably want a few blood tests done, at regular intervals, to assess the platelet counts.</p><p>Medical treatment does not actually cure ITP. Instead, it raises the platelet count for a period ranging anywhere from a few weeks to even months. If your child's ITP does not clear up spontaneously during this time, the platelet count will fall again. More therapy will be required until the ITP disappears spontaneously.</p><h2>Side effects of medication</h2><h3>Prednisone</h3><p>The most common side effect is weight gain due to increased appetite. It is characterized by a "moon face," "pot belly" and fat deposits on the back of the shoulders. These symptoms are temporary and will disappear when the drug is stopped.</p><p>Other side effects associated with prednisone include:</p><ul><li>acne</li><li>increased blood pressure</li><li>a change in the level of blood sugar</li><li>mood swings ranging from euphoria to temper tantrums</li></ul><p>If your child is taking prednisone and comes into contact with chicken pox, seek medical attention right away. Your child's doctor may want to change the type of treatment.</p><h3>Intravenous immunoglobulin</h3><p>The most common side effects are headaches, fever, and nausea. In most cases, these side effects occur when two treatments are given back-to-back (12 hours apart). Give your child <a href="/Article?contentid=62&language=English">acetaminophen</a> to relieve their headache and/or fever. Similarly, give your child dimenhydrinate to treat nausea and vomiting. Within 24 hours after the second dose of <a href="/Article?contentid=161&language=English">intravenous immunoglobulin</a>, the symptoms should disappear. If only a single dose of intravenous immunoglobulin is given, the chance of these side effects occurring is small.</p><h3>Intravenous Anti-D</h3><p>The most serious side effect is a drop in the level of haemoglobin (red cells) in the blood. The biggest drop will occur seven to 10 days after the Anti-D has been given. Your child may appear tired and pale. In most cases, the haemoglobin does not drop low enough to require a transfusion.</p><h2>Medications to avoid</h2><p>If your child has ITP, always check with their doctor before giving them any medication. <a href="/Article?contentid=77&language=English">Acetylsalicylic acid</a> (ASA) or any medication that contains ASA should be avoided. This is because ASA interferes with platelet function for a period of seven to 10 days. If your child has a low platelet count, this may increase their risk of bleeding. All over-the-counter cough and cold medications should be carefully checked before being bought. If you are unsure if a medicine contains ASA or not, check with your pharmacist.</p><p>The following is a short list of medicines that should not be given to your child with ITP:</p><ul><li>ASA and all compounds that contain it</li><li>antihistamines</li><li>non-steroidal anti-inflammatory drugs (NSAIDs)</li><li>vitamin E</li><li>cod liver oil</li></ul><h2>ITP and physical activity</h2> <p>Your child's level of physical activity should be restricted until their platelet count surpasses 50,000 per microlitre. Speak to your child's doctor about these restrictions. Limiting physical activity will decrease the risk of bleeding from injury or trauma.</p> <p>Contact sports like soccer, football and hockey should be avoided until your child's platelet count has reached 100,000 per microlitre. Swimming is allowed but diving is not. If your child rides a bicycle, make sure they always wear their helmet. A bump or blow to the head could result in bleeding into the brain. If your child does hit their head, seek medical attention right away.</p> <p>Toddlers should be closely supervised to reduce their risk of falls and tumbles from chairs, tables and stairs.</p> <h2>ITP and dental care</h2> <p>Your child should continue to see their dentist. However, a platelet count is necessary before any invasive work is done. If their platelet count is too low (below 50,000 per microlitre), work such as cleaning, filling and tooth extractions should be avoided until the count rises to a safe level. Decisions regarding dental treatment should be made by your child's dentist and doctor.</p> <h2>ITP and immunizations</h2> <p>Your child should not receive their immunizations, especially those that contain live attenuated viruses. These include the measles, mumps, rubella (MMR) and oral polio vaccines. Also, intramuscular injections (injections into a muscle) should not be given. Once your child has recovered from ITP, they will then be able to receive any missed immunization.</p><h2>Prognosis of ITP</h2> <p>In most children, ITP is a self-limiting disease. About 80% to 90% of patients recover spontaneously, usually within three months from the beginning of the illness. This is called acute ITP. In a small percentage of patients, the disease will persist for six months or longer. This is called chronic ITP. Recurrence of ITP is uncommon but may occur up to several years after the initial episode. This is sometimes associated with another viral infection.</p>Idiopathic thrombocytopenia purpura (ITP)

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