OVERVIEW
OVERVIEW
Idiopathic thrombocytopenic purpura in children is a bleeding disorder associated with viral infection and characterized by bleeding from the skin or mucous membranes. The main manifestations are small bleeding spots and purple spots on the limbs, or nosebleeds and gum bleeds.
Whether medical insurance
Yes
Department
Hematology
Alias
Post-infectious thrombocytopenic purpura
Clinical Symptoms
Skin bruises and bruises, nosebleeds, gum bleeds, chills, high fever, hematuria, etc.
Hazards
A small number of patients with severe thrombocytopenia can be complicated by intracranial hemorrhage, which can be life-threatening.
Complications
Gastrointestinal bleeding, pulmonary hemorrhage, intracranial hemorrhage, etc.
Examination
Physical examination, blood routine, bleeding time, bone marrow examination, platelet anti-human globulin test, X-ray film, ultrasound, etc.
Diagnosis
Diagnosis can be made on the basis of history of infection and bleeding manifestations, combined with laboratory examination, bone marrow examination, and bundle arm test.
Treatment principle
Patients with idiopathic thrombocytopenic purpura in children have relatively mild symptoms, and most of them can resolve spontaneously within a few weeks, so they can be left untreated. For those with more severe bleeding, glucocorticoids, high-dose human gammaglobulin intravenous drip, immunosuppression, splenectomy and other treatments can be taken as appropriate.
Curability
More than 80% of patients can eventually return to normal regardless of treatment. In severe cases, the symptoms can be improved by active treatment, and some patients may become chronic. The disease is benign. A small number of patients with severe thrombocytopenia may die as a result of intracranial hemorrhage.
Dietary advice
Diet should be high protein, high vitamin and easy to digest.
Etiology
Etiology
There is usually a history of viral infection before the onset of the disease. Thrombocytopenia occurs after recovery from viral infection and may be related to the immune response due to viral infection.
Symptoms and Diagnosis
Typical symptoms
Generally, the onset of the disease is rapid, with chills, fever, and obvious bleeding spots, purple spots and bruises on the skin, which are unevenly distributed and usually start on the limbs and gradually spread to the trunk. Mucosal hemorrhage is manifested as nosebleed, gum bleed, blood blisters in oral and tongue mucosa, occasionally gastrointestinal and genitourinary bleeding.
Diagnostic basis
1. history of antecedent viral infection. 2. clinical manifestations of skin and mucosal bleeding. 3. decreased platelet count. 4. bone marrow examination shows megakaryocyte hyperplasia and impaired maturation. 5. platelet aggregation and platelet anti-human globulin test are positive. 6. beam arm test is positive.
Treatment
Treatment guidelines
Pediatric patients with relatively mild symptoms, most of which resolve spontaneously within a few weeks, may be left untreated. For those with more severe bleeding, glucocorticoids, high-dose human blood gammaglobulin intravenous drip, immunosuppression, splenectomy and other treatments can be taken as appropriate.
Drug treatment
1. glucocorticoid: can improve vascular integrity and reduce bleeding, drug immune thrombocytopenia can be applied, according to the condition of the choice of oral or intravenous drip. 2. human blood gammaglobulin: for hormone ineffective cases can be a trial of high-dose human blood gammaglobulin intravenous drip. 3. immunosuppressant: such as perphenazine, cyclophosphamide, are effective.
Prognosis
More than 80% of patients can eventually return to normal regardless of treatment. In severe cases, the symptoms can be improved by active treatment, and some patients can turn into chronic ITP.This disease is benign, but a few patients with severe thrombocytopenia can be complicated by intracranial hemorrhage and die.
Nursing care
Daily care
1. Keep the patient’s body clean, prevent the spread of bacteria in the body, do a good job of oral care, perineum and anus care, to prevent all kinds of infections. 2. According to the condition of the treatment, regular review. 3. Chronic purple epilepsy, according to the physical strength, can be appropriate exercise. 4.
Dietary management
1. Give high-protein, high-vitamin and easy-to-digest foods. 2. Avoid eating hard and coarse foods. 3.