Blanchette et al graded the severity of clinical bleeding in children with acute idiopathic thrombocytopenic purpura.


Moderate bleeding:

(1) localized bruising or petechiae

(2) generalized bruising or petechiae

(3) moderate mucosal hemorrhage

(4) epistaxis requiring therapy but not requiring red blood cell transfusion


Severe bleeding - one or more of the following:

(1) extensive mucosal hemorrhage

(2) marked increase in extent of bruising and/or petechiae (after admission to the hospital)

(3) fundal (optic) hemorrhage

(4) epistaxis requiring red blood cell transfusion

(5) macroscopic hematuria

(6) gastrointestinal bleeding (clinical, as opposed to guiac positive stool)

(7) intracranial hemorrhage


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