Current controversies in the management of idiopathic thrombocytopenic purpura during childhood

Idiopathic thrombocytopenic purpura is one of the more common acquired bleeding disorders encountered by pediatricians. Despite numerous studies of possible therapeutic options for this disorder, ongoing controversy exists regarding the management of affected children. This article reviews the presentation and diagnosis of idiopathic thrombocytopenic purpura and discusses three subjects relevant to its treatment and prognosis: (1) multicenter randomized clinical trials aimed at defining the most rapid means of raising the platelet count in acute idiopathic thrombocytopenic purpura; (2) the frequency of and risk factors for intracranial hemorrhage; and (3) the natural history of chronic idiopathic thrombocytopenic purpura during childhood.