Intracranial hemorrhage in a child with acute immune thrombocytopenic purpura

ABSTRACT Immune thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by a low circulating platelet count caused by destruction of antibody-sensitized platelets in the reticuloendothelial system. This disease is estimated to a?ect 1.9 to 6.4/100,000 children/year. Classical features include a previously healthy child with sudden onset of excessive bruising, petechiae and/or mucosal bleed. In extremely rare cases, a child with acute ITP can present with spontaneous intracranial hemorrhage (ICH). The incidence of ICH in children with ITP was established as 0.1%–1.0%. We reported a baby boy of 1 month and 16 days who was admitted at Sanglah Hospital with generalized cutaneous petechiae, mucosal bleed, and seizure. His head CT scan revealed ICH in left occipitoparietal and frontal area. Laboratory investigation showed normochromic anemia with thrombocytopenia. The patient received packed red cell and thrombocyte transfusion with high-dose methylprednisolone and intravenous immunoglobuline treatment. His condition continued to improve day by day and the thrombocyte count increased above 100.000/mm3 after 10 days of hospitalization. This case showed good response to treatment with high-dose methylprednisolone and intravenous immunoglobulin. Keywords: immune thrombocytopenic purpura, child, intracranial hemorrhage