Case Conversation: An Update on Pediatric Immune Thrombocytopenia (ITP)
This is a recorded version of the webinar on Case Conversation: An Update on Pediatric Immune Thrombocytopenia (ITP): Differentiating Primary ITP, IPD, and PID that was presented live on May 24, 2022. Please scroll all the way down this page to view the archived webinar.
Webinar Date: 5/24/22
Estimated Time to complete: 1 hour
Format: Archived Webinar
Target Audience: Primary Care Physicians, Specialty Physicians (Ob/Gyn, Oncology, Hematology), Physician Assistants, Advanced Nurse Practitioners, Registered Nurses, Licensed Practical Nurses, Registered Nurses in Specialty Areas (Ob/Gyn, Oncology, Hematology)
Immune thrombocytopenia (ITP) is the most common acquired thrombocytopenia in children and is caused by both immune-mediated decreased platelet production and increased platelet destruction. In the absence of a diagnostic test, ITP must be differentiated from other thrombocytopenic disorders, including inherited platelet disorders (IPD). In addition, a diagnosis of secondary ITP due to a primary immune deficiency (PID) with immune dysregulation may not be apparent at diagnosis but can alter management and should be considered in an expanding number of clinical scenarios.
The diagnostic evaluation of children with thrombocytopenia will vary based on the clinical history and laboratory features. Access to genotyping has broadened the ability to specify the etiology of thrombocytopenia, while increasing access to immunophenotyping, functional immunologic and platelet assays, and biochemical markers has allowed for more in-depth evaluation of patients. With this greater availability of testing, diagnostic algorithms in patients with thrombocytopenia have become complex. In this article, we highlight the diagnostic evaluation of thrombocytopenia in children with a focus on ITP, including consideration of underlying genetic and immune disorders, and utilize hypothetical patient cases to describe disease manifestations and strategies for treatment of pediatric ITP.
After completing this educational activity, participants should be able to:
- Describe key features of patients with thrombocytopenia that warrant further diagnostic evaluation for inherited platelet disorders or inborn errors of immunity
- Explain the indications for and utility of molecular analysis for pediatric patients with thrombocytopenia
- Delineate a diagnostic and therapeutic algorithm for pediatric patients presenting with thrombocytopenia
Rachael F. Grace, MD, MMSc
Associate Professor of Pediatrics
Harvard Medical School
Michele P. Lambert, MD, MSTR
Department of Pediatrics
Perelman School of Medicine at the University of Pennsylvania