When a child has thrombocytopenic purpura, their blood platelet count is reduced below normal, which can be concerning for parents. Lack of platelets can easily cause bruising and bleeding because they are essential for blood clotting. Comprehending this ailment is imperative in order to identify its indications and promptly seek medical guidance.
Thrombocytopenic purpura comes in a variety of forms, with differing causes and degrees of severity. Certain forms are transient and associated with infections or other ailments, whereas others may be chronic and necessitate continuous care. Determining the right course of action and care requires identifying the underlying cause.
This article will define thrombocytopenic purpura, discuss possible causes, and discuss management options for children with this condition. Parents can better support their child’s health and well-being by learning more about this condition.
Etiology
There are numerous hemorrhagic pathologies in existence today. There are several factors that contribute to their growth. Thrombocytopenic purpura is one of these illnesses. When it comes to hemorrhagic diseases in both adults and children, this pathology is the most common. Based on statistical analysis, it can be observed that 40-70% of patients with different blood pathologies experience it. A significant reduction in the total number of platelet cells in the peripheral circulation is the hallmark of this pathology. The immune conflict that exists between antigens and platelets is the cause of this. It is noteworthy that the spleen’s anatomical parameters are still normal. Physicians have observed an increasing number of cases of this hemorrhagic illness reported annually.
This pathology affects babies far more frequently than it does boys.
- Long-term use of certain types of drugs. Scientists have proven that more than 60 different drugs can provoke the appearance of symptoms of this hemorrhagic disease on the skin of a child. Such drugs include quinine, quinidine, sulfonamides, heparin, furosemide, dipyridamole, digoxin, metabolites of acetylsalicylic acid, paracetamol, some types of beta-blockers, thiazides, cephalosporins, ampicillin, levamisole and many others. Predicting the development of hemorrhagic disease in a particular child is an almost impossible task.
- Genetic defects. Many European scientists believe that heredity plays a very important role in the development of the idiopathic variant of the disease. Numerous scientific experiments are currently being conducted to prove or disprove this theory. Existing genetic disorders can lead to the development of autoimmune inflammation and the appearance of unfavorable symptoms of hemorrhagic disease.
- Consequences of past infectious pathologies. The toxic effect of waste products of pathogenic microorganisms on the child"s body leads to the development of various inflammatory immunological reactions. In children with congenital immunodeficiency states, the risk of thrombocytopenic purpura is increased several times.
- Intrauterine infection. The first signs of hemorrhagic disease are formed in the baby while still in the womb. A woman suffering from thrombocytopenic purpura can transmit a number of autoimmune antibodies to the child through the placental bloodstream. This clinical situation leads to the fact that unfavorable symptoms of the disease occur in a newborn baby already in the first months of life.
Pathogenesis
For an extended period, researchers were unable to determine the mechanism underlying the development of pediatric thrombocytopenic purpura. Numerous theories have been upheld for many years to explain the pathophysiology of this hemorrhagic illness. Recent advancements in diagnostic techniques and the introduction of new laboratory equipment have led to new understandings regarding the mechanism underlying the development of pediatric thrombocytopenic purpura.
The child’s body begins to contain a large number of particular protein molecules during the pathological process. We refer to them as antiplatelet antibodies. These compounds start to interact with specific antigenic elements of blood platelets’ (thrombocytes’) cell membranes.
These blood cells typically carry out a multitude of crucial physiological processes. They are required for both blood flow and normal viscosity.
Recent research findings verify that this hemorrhagic disease causes several structural alterations in platelets. They exhibit a prominent granular apparatus and a marked elevation in alpha-serotonin levels. The onset of long-lasting alterations in the vascular wall is influenced by variations in the overall platelet count. The amount of platelet growth factor rises in response to this state.
Endothelial cells, which line the inside of blood vessels and give them a particular "smoothness" required for continuous blood flow, die as a result of all these disorders. These pathological deviations cause the child to exhibit the initial symptoms of hemorrhagic syndrome, which has a severe negative impact on his health.
Antiplatelet antibodies typically manifest 0.5–1 month following bacterial or viral infections. They are members of the immunoglobulin G class by affiliation. This also establishes whether the antibodies will continue to be preserved and eventually show up in the blood. In certain instances, they may endure throughout the child’s lifetime. The spleen is where "used up" immune complexes die.
The most recent findings in scientific research have helped to explain why a child with autoimmune thrombocytopenic purpura experiences prolonged symptoms of increased bleeding. The main cause of this is a drop in serotonin levels. This material typically plays a role in the development of a blood clot.
Types
Physicians distinguish between various clinical manifestations of this hemorrhagic illness.
Among them are:
- immune thrombocytopenia;
- idiopathic.
Physicians also employ an additional classification scheme that permits the differentiation of various thrombocytopenic purpura variants into distinct immune forms. Among them are:
- Isoimmune. Most often occurs after blood transfusions. Can be congenital – when the mother and the future baby have an immune conflict on platelet antigens. Can be transient. This clinical form is often constantly recurring.
- Autoimmune. Occurs as a result of the formation in the body of a large number of platelet antibodies to its own blood platelets.
- Heteroimmune. The development of this immune variant of the disease is often caused by taking certain groups of drugs. An important role in this is played by the presence of individual hypersensitivity and intolerance to certain chemicals in the sick baby. This contributes to the development of a specific symptom – purple rashes on the skin, which are a consequence of multiple hemorrhages.
- Transimmune. This immune form of the disease develops, as a rule, as a result of an antigen conflict and the accumulation of antiplatelet antibodies in a pregnant woman. They penetrate the fetus"s body quite easily through the placental blood flow system, leading to the development of hemorrhagic syndrome.
Children with thrombocytopenic purpura have an abnormally low blood platelet count, which makes bleeding and bruising easily. Many conditions, such as disorders of the immune system or problems with the bone marrow, can lead to this condition. To control symptoms and avoid complications, early diagnosis and treatment are essential. Parents and other caregivers can help afflicted children receive the best care by being aware of the symptoms, causes, and available treatments.
Symptoms
The degree to which the decrease in platelets in the peripheral blood is critical determines how severe the adverse clinical signs of the disease are. When platelets fall to 100,000/μl, symptoms worsen. When the level falls to 50,000/μl, hemorrhagic syndrome symptoms become more noticeable.
The most distinct clinical manifestation of thrombocytopenic purpura is this pathological state. Numerous, diverse hemorrhages that appear in a range of anatomical locations are what define it.
While nosebleeds and gum bleeding are common in sick children, internal organ and brain hemorrhages are the most serious. The sick baby becomes disabled as a result of this.
Blood in the urine is a sign of bleeding in the kidneys or urinary tract in children. Hematuria, or the presence of a significant amount of red blood cells in the urine sediment, can be brought on by heavy bleeding. The child experiences black stool (melena) when there is bleeding in the gastrointestinal tract, particularly in the distal portions of the intestine. These clinical indicators are highly detrimental and necessitate immediate medical attention.
There are various characteristics of hemorrhagic syndrome in thrombocytopenic purpura. It is distinguished by the complete spontaneity of the deviations’ appearance as well as their asymmetry. Generally speaking, the severity of the signs does not match the force of the impact.
Adverse effects can sometimes manifest in a child after only one medication dosage or following a common infection. Thrombocytopenic purpura frequently manifests as an acute form.
Multiple simultaneous hemorrhages are possible (in a variety of internal organs). Internal bleeding can also occur in quite unfavorable localizations. These include the liver, heart, brain, spinal cord, kidneys, and adrenal glands. Vital functions are severely disrupted by hemorrhages in these organs.
The symptoms of thrombocytopenic purpura are specific. The spleen and liver do not appear to be enlarged when the internal organs are palpated. The size of lymph nodes also stays normal. This pathology can be distinguished from many other hemorrhagic diseases by these clinical signs. The syndrome of increased bleeding is frequently only one sign of this illness.
How it manifests itself in newborns?
When a baby has blood autothrombocytic antibodies, the symptoms start to show up in the first few months of life. Hemorrhagic syndrome in infants can manifest itself in a variety of ways. The baby’s initial state and the existence of serious concurrent pathologies both affect when negative symptoms manifest.
Infants with thrombocytopenic purpura present with internal organ hemorrhages as well as skin and mucous membrane hemorrhages.
Large bruises that appear on the skin suddenly are usually the first signs that parents notice in a sick child. Before such elements appear on the skin, there are typically no prior blows or injuries. Hemorrhages developing in the cavity of large joints are extremely dangerous because they can cause pain to appear during active movements and disturb gait.
Diagnostics
When a child experiences multiple hemorrhages, the condition may be suspected. These kinds of symptoms are typically absent in infants. The emergence of bruises on the skin that have nothing to do with a blow or injury should also prompt parents to take their child to the pediatrician. A more precise diagnosis can be made by a pediatric hematologist.
Doing diagnostics in the lab requires a number of tests. The pathological variation of bleeding and the severity of the child’s current physiological disorders are both established by these studies.
Two tests are used to determine excessive bleeding: the "pinch test" and the "cuff test." When thrombocytopenic purpura is diagnosed, a blood pressure study using a children’s tonometer cuff is required.
A general blood test is a fundamental investigation that is carried out for every child, without exception. A dramatic drop in platelet counts is a hallmark of this hemorrhagic illness. Long-lasting lymphocytosis following viral infections may be seen in the blood. For thrombocytopenic purpura, a spinal puncture is merely a necessary procedure. A myelogram for this illness will reveal that the platelet count is within normal limits.
A coagulogram analysis is carried out to identify any functional disorders that may already exist. It facilitates the measurement of fibrinogen content, prothrombin time, and other critical parameters for evaluating the development of intravascular thrombus. The attending physician makes an assessment of the outcome.
An enlargement of the diagnostic measure complex is necessary in certain circumstances. Extensive research is recommended for specific medical indications.
| Aspect | Description |
| Definition | Thrombocytopenic purpura is a condition where a child has a low platelet count, leading to easy bruising and bleeding. |
| Symptoms | Common symptoms include unusual bruising, frequent nosebleeds, bleeding gums, and petechiae (small red or purple spots on the skin). |
| Causes | The condition can be caused by autoimmune disorders, infections, certain medications, or as a side effect of other health issues. |
| Diagnosis | Diagnosis is usually made through blood tests, which check platelet levels, and may include a bone marrow biopsy if needed. |
| Treatment | Treatment depends on the underlying cause and may include medications, blood transfusions, or treatments to address the specific cause of the low platelet count. |
| Prognosis | With appropriate treatment, many children recover fully or manage the condition effectively, though outcomes can vary depending on the cause. |
Although concerning, thrombocytopenic purpura in children is treatable with the right medical attention. In order to manage the condition and reduce complications, early diagnosis and treatment are essential. A child’s health and well-being can be greatly improved by being aware of the symptoms and getting medical help as soon as possible.
In order to support their child’s treatment and recovery, parents are essential. Effective management of the condition can be achieved by adhering to treatment plans, keeping track of medical appointments, and being alert for any changes in symptoms. Most kids with thrombocytopenic purpura can have healthy, active lives if they receive the proper care.
Despite the condition’s intimidating appearance, it’s crucial to keep in mind that advancements in medicine offer practical solutions. Children with this condition continue to have better outcomes thanks to ongoing research and advancements in treatment options. The best way to support your child’s health and make sure they receive the care they require is to be proactive and knowledgeable.
