9 yrs old / female Sudden onset purpura on body at 6_7 places .... Purpura over the body noticed around 5pm on 26/8/2022 After that we went to the nearby hospital ... Where she was admitted ... And her cbc report showing only 5 thousand platelets .. Where she got transfused a jumbo platelets.. Next day they referred us to .. meerut .. Where a senior pediatrician told us that it seems ITP... And we should go ivig On 27/8/2022... according to weight she recently 25 gms ivig .. After ivig after 48 hrs she was having platelets 8 thousand... But in the very next cbc she is having only 5 thousands platelets again..... On examination _ no hepatomegaly No spleenomegaly No lymph node palpable.. No other symbols like fever , loose motions , diarrhoea , cough .. Kindly give your valuable opinion

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Looks like itp . Check for prolonged bleeding time and comment on peripheral smear for megakaryocytes . As it's autoimmune disorder there's no role of giving platelet transfusion they will ultimately get destroyed . I think she has recieved less dose of ivig total dose 2 gm/kg. Over 72 hours to 5 days . Or alternatively inj methylpred 30 mg/kg/hour pulse therapy over 1 hour for 3 to 5 days .

NEED'S .. CLINICOPATHOLOGICAL EVALUATION WITH .. BLOOD CBC .. CT BT PT .. MP .. WIDAL .. DENGUE FEVER TESTS .. USG STUDY .. MALENA .. DRUG HISTORY .. HEMATOLOGIST OPINION ..

Do USG bt ct Do dengu test Crp Ask the melena Family history need

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