Management of chronic ITP in children Plz give your valuable opinion
General cause of About Idiopathic Thrombocytopenia Purpura (ITP) in Children.... is a blood disorder with decreased blood platelets, which may result in easy bruising, bleeding gums and internal bleeding. The cause is usually unknown, but it may be an autoimmune disorder or follow a viral illness. Best possible management by Corticosteroid treatment with its protocol.
* FIRST LINE TREATMENT.. IVIG .. STEROIDS.. * SECOND LINE TREATMENT.. SPLENECTOMY.. IMMUNOSUPPRESSIVES THERAPY.
Chronic ITP is uncommon in pediatric patients. Make sure this is not an inherited low platelet disorder!! I see it commonly where a patient has been treated for years for "ITP" where as it is an inherited platelet disorder. History specially bleeding history and family history and testing other family members is important.
Advised Steroids Immunoglobulines I v Splenectomy
Platelet transfusion steroids splenectomy
High dose dexamethasone followed by a maintenance course IVIG only in needs Rituximab (excellent response in many cases)
First line therapy. Intravenous IG . Corticosteroids. Second line therapy. Surgical removal of spleen. Immunosuppressive.
High dose steroids IV I Immunosuppressive therapy Rituximab If not respond than splenomegaly
Corticosteroid Intravenous immunoglobulin s
Cases that would interest you
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A 45 year old male, a non alcoholic with no major illness in past, presented with fever since 5 months( on and off, high grade, no joint pain) . Gen weakness since 5 month. Patient had a history of cavity in tooth and abscess there which was extracted locally near his residence.he was also prescribed antibiotics for the same. Now patient reffered to us with severe anaemia and blackish brown spotts over fingertips of all 4 extremeties. Pallor +++ Platelets low 58000 as mentioned. Spleen 2 cm below costal margins. Cva normal, no signs of SABE Bilirubin normal. He was earlier treated for enteric fever and megaloblastic anemia in some hospital where blood culture was normal and all other reports attached( white ones) Gbp is awaited. Marrow is planned once platelets are normal. Givin 2 units of prbc. What will be the dd and further management plan. Hb fall from 7 to 3 in three days duration. With no signs of hemolysis.
Dr. Rishabh Dixit12 Likes50 Answers - Login to View the image
A girl age 16yrs c/o parpura like rashesh over the legs nd itching on nd off no any bleeding hstory Inv CBC normall usg no hepatosplenomegaly splenomegaly Plz Ur valuable opinion
Dr. Patel Sadique2 Likes22 Answers - Login to View the image
60 yo male with 5 week history of petechial rash spreading from lower extremities to abdomen. Accompanied with some burning. Otherwise asymptomatic. Patient is smoke. Whats diagnosis and tmt
Dr. Vivek Jain5 Likes44 Answers - Login to View the image
5yrs old male child came with c/o bleeding from rt ear and nose after fall during play. O/E minimal bleed from nose and rt ear. many perpuritic and ecchymotic patches over body. more on forearms and face on right side. boy is otherwise healthy concious oriented active and playful; have no fever cough cold in recent 4 to 5 days. ? neither have h/o the same in last 2 to 3 weeks as per mother. he inverstigated for the same by some general practitioner cbc 6.8/7500/20.000 other routine tests are normal including BT, CT and PT INR and dengue profile. differentials.
Dr. Rahul Patil1 Like20 Answers - Login to View the image
a nine year old girl with history of cough, high grade fever since 4 months with chills and rigor with pain in body with h/o epistaxis with hb- 4 ,platelet count 26000 tlc 17700 chest b/l ronchi . on Att for abdominal Koch's. pallet with tachycardia. ps- anisopoikilocytosis macrocytic anaemia. h/o multiple joint pain. petechiae all over face since 5 days. USG Abdomen shows hepatomegaly. CERVICAL ADENITIS tender. likely d/d and management.
Dr. Abhishek30 Likes61 Answers