ITP – Our personal storyGreetings friends and patients! With the new school year coming up comes an opportunity for keeping in touch with friends and patients through the Beach Kids Pediatrics blog! On a personal note, our son, Taylor, who is now 4 years old, was recently diagnosed with ITP, or Immune Thrombocytopenic Purpura. This illness is an auto-immune condition in which the person’s immune system suddenly starts recognizing its own platelets as foreign and begins to attack them and remove them from the circulation. As a result, the platelet count in the blood drops drastically and the person becomes prone to bruising easily and is at risk for uncontrolled bleeding. Most experts believe the illness is usually triggered by a viral illness or other event which stimulates the immune system, such as a vaccination.

Although I had been familiar with this condition as a pediatrician, it is, of course, a different story dealing with the condition as a parent.  It is quite nerve-wracking watching our son tear around the house with his younger brother in his usual manner of suddenly becoming extremely active right before bedtime. I have been told by our hematologist to be extra careful that he doesn’t hit his head. So I don’t let him ride his tricycle, I try to not let him jump on the bed, I only take him to playgrounds where there aren’t a ton of other kids running around, etc. But I also want him to be able to have fun, so I try not to worry too much. Most kids who get ITP between ages 2 and 6 will recover fully within six months, so we are hopeful that his platelet count will go up soon. Some kids, however, will go on to have chronic ITP, in which the platelet count stays low for years.

The presenting symptom of ITP is increased brusing and a petechial rash. It is quite important for parents to be able to recognize a petechial rash, because it can be indicative of either a blood disorder like ITP, or a serious bacterial infection, such as meningococcemia. The petechial rash, also called petechiae, looks like tiny little red dots clustered together on the skin. It results from tiny capillaries bursting underneath the skin. The dots are completely flat, ie., you can NOT feel them. Many people comment that the petechiae look like a scrape, but the important distinguishing factor is that you can feel a scrape. When you press on the petechial rash, it does NOT blanch temporarily, ie., turn white for a few seconds, as many other rashes do. It is often referred to as a non-blanching rash.  If you suspect this rash in your child, you should take him to your pediatrician right away to be evaluated.