Criteria of Medeiros and Buchanan for Major Hemorrhage in a Child with Acute Idiopathic Thrombocytopenic Purpura (ITP)

 

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