Acute immune thrombocytopenia in childhood. Are we treating the platelet count?

Acute immune thrombocytopenia (ITP) in children is a benign disease, presenting mostly with skin purpura and minor bleeds. It has a high rate of spontaneous remission. Intracranial hemorrhage (ICH) is extremely rare; the risk is higher during the chronic phase and in children with additional risk factors. The threshold platelet count in ITP is not known because of problems with platelet counting in thrombocytopenia and the lack of clinical data. The threshold is probably lower than in leukemia, because primary hemostasis is better in ITP. So far, there is no proof for the clinical efficacy of treatment or prophylaxis with intravenous immunoglobulin (IVIg) and glucocorticoids (GC), medications that have several adverse effects. The question remains open whether or not we are treating the platelet count in children with acute ITP.