Medeiros and Buchanan listed to criteria to identify a child with acute idiopathic thrombocytopenic purpura (ITP) who has major hemorrhage. The authors are from the University of Texas Southwestern Medical Center and Children's Medical Center in Dallas, Texas.


Criteria for major hemorrhage - one or more of the following:

(1) intracranial hemorrhage

(2) epistaxis that requires nasal packing or cautery

(3) gross hematuria

(4) mucosal or cutaneous severe enough to cause a decline in the hemoglobin

(4a) <= 10 g/dL OR

(4b) fall from baseline >= 2 g/dL


The authors noted:

(1) only 17% of children with acute ITP had a major hemorrhage

(2) most children with major hemorrhage did not show an immediate rise in the platelet count after receiving corticosteroids and/or intravenous immunoglobulin


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