Clinical manifestations and evaluation of thrombocytopenia in children
- Donald L Yee, MD
Donald L Yee, MD
- Associate Professor of Pediatrics
- Baylor College of Medicine
- Section Editors
- Donald H Mahoney, Jr, MD
Donald H Mahoney, Jr, MD
- Section Editor — Pediatric Hematology
- Professor of Pediatrics
- Baylor College of Medicine
- Lawrence LK Leung, MD
Lawrence LK Leung, MD
- Editor-in-Chief — Hematology
- Section Editor — Disorders of Hemostasis and Coagulation
- Professor of Medicine
- Stanford University School of Medicine
Thrombocytopenia, defined as a platelet count <150,000/microL, is clinically suspected when a child develops characteristic clinical symptoms, which include a petechial rash, easy bruising or bleeding, or mucosal hemorrhage. Thrombocytopenia is often asymptomatic and may present as an incidental finding during routine evaluation or during laboratory investigations performed for other reasons. A common cause of thrombocytopenia in children is immune thrombocytopenia (ITP, previously known as idiopathic thrombocytopenic purpura), for which the consensus definition is more restrictive, requiring a platelet count <100,000/microL .
The clinical manifestations and evaluation of thrombocytopenia in children will be reviewed here. Topic reviews with information relevant to the child with thrombocytopenia include the following:
- Rodeghiero F, Stasi R, Gernsheimer T, et al. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group. Blood 2009; 113:2386.
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- Monteagudo M, Amengual MJ, Muñoz L, et al. Reticulated platelets as a screening test to identify thrombocytopenia aetiology. QJM 2008; 101:549.
- PLATELET COUNT AND BLEEDING RISK
- CLINICAL MANIFESTATIONS
- Cutaneous bleeding
- Mucosal bleeding
- Intracranial hemorrhage
- Verification of thrombocytopenia
- Physical examination
- Laboratory evaluation
- - Complete blood count
- - Peripheral blood smear
- - Bone marrow examination
- - Other tests
- - Reticulated platelets
- SUMMARY AND RECOMMENDATIONS