Immune thrombocytopenia and how to monitor the condition?

  Is the child prone to relapse when his or her disease is stable?  When the child is treated, the disease will stabilize and the blood count will gradually rebound. However, when the immune system has not yet recovered, immune thrombocytopenia is prone to relapse if stimulated by an exogenous infection. Platelets may also drop again if the child’s disease disease is temporarily stabilized and is stimulated by a sudden cold.  How is ITP treated after a relapse?  First-line therapy (glucocorticoid or gammaglobulin therapy) is preferred after a relapse and is currently considered to be the most beneficial. Children’s immune systems are not yet stable, and it is possible that the disease will recover once the immune system is stabilized.  How often is the child reviewed when his or her disease does not recover? What is reviewed each time?  Usually the review is once every six months to a year. It is important to assess the disease status to determine which items to check. Sometimes the disease presents early as ITP, only to be reviewed later to find that it may be another disease, such as lymphoma, megakaryocytic leukemia, remittent disease, lupus erythematosus, etc. This is because the immune system in children is unstable and immune diseases develop to a stage where they manifest only as thrombocytopenia, which is very similar to ITP, and as the disease progresses, the underlying lesions only become apparent later and sometimes there is a switch in disease. There are also congenital thrombocytopenia-like disorders. Therefore, it is important to review the unsatisfactory results of treatment and the prolonged course of the disease.  What is the platelet value of the child to be controlled at the time of general treatment?  There are two criteria. The first one is to control the platelet value to at least 20×109/L to 30×109/L, which is sufficient to meet the child’s daily needs; the second one is to ensure that the child does not bleed, depending on the child’s individual condition.  What kind of bleeding will threaten the child’s life?  We are most concerned about intracranial hemorrhage, which is the most dangerous and frightening. This is the most dangerous and frightening, followed by gastrointestinal bleeding. There are also specific areas of bleeding such as the neck, eyes, etc.