Thrombocytopenia refers to a low blood platelet count. This can lead to bruising easily or bleeding excessively.

In children, acute immune thrombocytopenia (ITP) is relatively common, and it may develop after a viral illness, such as chickenpox. In other cases, the condition is long lasting. It may stem from the use of medications or a genetic mutation.

If a child has acute ITP, they usually recover within 6 months, and if the condition is mild, they may not need any treatment.

Below, learn more about thrombocytopenia in children.

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A low blood platelet count can result from many factors.

Acute ITP

Researchers believe that viruses, such as the one that causes chickenpox, can temporarily alter how a child’s immune system behaves and cause it to attack platelets, resulting in acute ITP.

This issue is more common in children 2–6 years old. Usually, the symptoms are mild and go away on their own within 6 months. However, 1 in 5 children with the condition go on to develop chronic ITP.

Chronic ITP

This is rare in young children and is more common in adolescents and adults, particularly in females. It may last for several months or a lifetime and require specialist treatment. In some people, chronic ITP seems to resolve but recurs often.

Drug-induced thrombocytopenia

Thrombocytopenia can develop in response to medication, and this can be life threatening in newborns and other young children.

In a 2019 case study and review, a baby had a severe drop in their platelet count after receiving ranitidine (Zantac) for trouble feeding. Ranitidine can also treat acid reflux.

Fully understanding the effects of ranitidine and similar drugs on the platelet count in babies and young children requires more research.


Several infectious diseases can reduce platelet levels and cause secondary thrombocytopenia. Some of these illnesses include HIV, dengue fever, and malaria.

Malaria, in particular, can lead to a severe reduction in a child’s platelet levels, a 2021 study confirms. The authors suggest that the presence of thrombocytopenia may be a reliable indicator of malaria in children.

MYH9-related thrombocytopenia

This form of thrombocytopenia is distinct because the reduced platelet count results from a genetic mutation, rather than the immune system attacking the body’s platelets.

The MYH9 gene is responsible for building proteins that occur in certain blood cells, including platelets. A person can inherit this mutation from their parents or develop it spontaneously.

Several diseases involve a mutation of the MYH9 gene, and all of them can cause thrombocytopenia:

  • Epstein syndrome
  • Fechtner syndrome
  • May-Hegglin anomaly
  • Sebastian syndrome

Aplastic anemia

Aplastic anemia is a form of bone marrow failure, and it can cause thrombocytopenia. As the bone marrow shuts down, it produces fewer red and white blood cells and platelets.

In most cases, aplastic anemia develops without any obvious cause, and doctors refer to this as “idiopathic” aplastic anemia. However, some children may inherit the condition or develop it after an infection.

Bone marrow failure tends to occur between the ages of 1 and 5 years or between the ages of 12 and 20 years.

One of the most telling symptoms is patches of bruising or purple areas of skin.

Additional symptoms include:

  • tiny red, rash-like spots
  • bleeding freely
  • bruising easily
  • having blood blisters in mouth
  • having blood in urine
  • heavy menstrual bleeding, in adolescents

The National Heart, Lung, and Blood Institute explains that doctors consider a person’s medical history and the results of a physical examination and tests when diagnosing thrombocytopenia and identifying its cause.

Medical history

A doctor may ask about anything that could affect platelet levels, including:

  • the use of prescription and over-the-counter medicines
  • general eating habits
  • any family history of a low platelet count or related conditions

Physical examination

During this, the doctor checks for signs of bruising and bleeding. They may also look for symptoms of an infection, such as a fever.

Diagnostic tests

If the doctor suspects thrombocytopenia, they run several tests, which may also determine the cause of this issue.

These tests may include:

  • A complete blood count: The results can confirm low platelet levels.
  • A blood smear: This shows whether the platelets appear healthy.
  • Bone marrow tests: This confirms bone marrow health.
  • Prothrombin time test: This measures the blood clotting rate in seconds.

When a child has thrombocytopenia, the treatment depends on the cause and the severity of the symptoms.

For example, a child with mild acute ITP likely does not need treatment, as this tends to resolve on its own. However, if the child is highly likely to bleed profusely, they may need a blood or platelet transfusion.

A child with chronic ITP that frequently recurs may need medication that suppresses the immune system, such as rituximab. If an infectious illness, such as HIV, is responsible, the doctor may prescribe corticosteroids, which slow platelet destruction.

Overall, the goal of thrombocytopenia treatment is to prevent serious complications. If an underlying health condition is causing the low platelet count, the doctor will focus on treating both issues.

Thrombocytopenia refers to low levels of platelets in the blood, which can increase the risk of bleeding and bruising easily.

Acute ITP is the most common form of thrombocytopenia in children, and it usually resolves on its own within 6 months. Less common causes of thrombocytopenia include medications, infections, and a genetic mutation.

If a child’s symptoms are very mild, they may not need treatment. A child with chronic ITP may have a risk of severe bleeding and need immunosuppressant medication.