Some childhood illnesses can appear without warning, scaring parents and doctors... and then, for no apparent reason, all the symptoms suddenly disappear.
That’s what seems to be happening to 10-yaer-old James, who came into the ER complaining of headaches, lethargy and bruising.
Doctor Lonnie King, of Children’s Healthcare of Atlanta examined James and notes that the bruises aren’t typical. They appeared spontaneously all over his body, and are signs of ‘ITP’.
Dr. King explains that ITP is, “ Idiopathic Thrombocytopenia Purpura. Idiopathic means: unknown case. We don’t know what causes it. And the thrombocytes are the small cells, or pieces of cells in the blood stream that help clot. Penia means low. And purpura is bruising. So he had bruising, because had had low platelet count of unknown cause.”
ITP is an autoimmune disorder: the body’s immune system attacks platelets that enable blood to clot.
A normal platelet count is 150-thousand or more, but James’ count was only 10,000 a few days ago… so low the doctor is worried about internal bleeding.
Doctor King explains to James’ concerned parents that the first step in treatment is to, “Prove that [James] doesn’t have a ruptured blood vessel, and see what his platelet count is, and we’ll talk to the hematologist.”
In rare cases a low platelet count can result in a ruptured blood vessel in the brain. So Doctor King orders a blood test and CT scan.
The results are quickly back, and they appear encouraging. “This is James’ CAT scan. And it looks totally fine,” says Dr. King, as he examines the brain images.
And his platelet count is rising. Dr. King gives the news to James and his parents. “Hey James, CAT scan’s normal, okay? And the platelet count is 56-thousand. It’s way up! So it’s good. So I think… you’re much, much better!”
That’s the way ITP is. In kids especially, symptoms can last a few days and then mysteriously go away.
“90 percent of these children will be spontaneously cured,” explains Dr. King, “and the disease will be gone within six to eight months.”
With a normal CT scan and increased platelet count, James can go home. But he’ll have to return to his doctor for regular checkups and blood tests, to monitor his condition.
Dr. King points out that the unexplained bruising associated with ITP often can be misdiagnosed as child abuse. He says if parents notice such bruising on their children, they should immediately ask the doctor to check for ITP.