The treatment of immune thrombocytopenic purpura in children.

Immune thrombocytopenic purpura (ITP) is an enigmatic, usually transient disorder in children, largely thought to be a self-limited, postinfectious, autoimmune phenomenon. The often strikingly low platelet count, coupled with the sometimes dramatic cutaneous manifestations of thrombocytopenia, compels most clinicians to prescribe drug therapy. However, closer scrutiny reveals that although most children with newly diagnosed ITP have platelet counts less than 10,000/microL, very few will experience severe or life-threatening hemorrhage, leading to perpetual controversy over whether to give drug therapy to minimally or moderately symptomatic children with ITP. This review focuses on when and how to use drug therapy to treat ITP in children.