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Blood, 26 November 2009, Vol. 114, No. 23, pp. 4777-4783. Prepublished online as a Blood First Edition Paper on September 18, 2009; DOI 10.1182/blood-2009-04-215525. This Article Full Text Full Text (PDF) All Versions of this Article: blood-2009-04-215525v1 114/23/4777    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Google Scholar Articles by Psaila, B. Articles by Bussel, J. B. PubMed PubMed Citation Articles by Psaila, B. Articles by Bussel, J. B. Related Collections Free Research Articles Platelets and Thrombopoiesis Clinical Trials and Observations Related Article in Blood Online Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  CLINICAL TRIALS AND OBSERVATIONS Intracranial hemorrhage (ICH) in children with immune thrombocytopenia (ITP): study of 40 cases Bethan Psaila1,2, Aleksandra Petrovic3, Lemke K. Page1, Jill Menell4, Matthew Schonholz1, and James B. Bussel1 1 Department of Pediatric Hematology-Oncology, Weill Cornell Medical Center and NewYork-Presbyterian Hospital, NY; 2 Department of Haematology, Imperial College School of Medicine, Hammersmith Hospital, London, United Kingdom; 3 Pediatrics, Department of Blood and Marrow Transplant, All Children's Health System, St Petersburg, FL; and 4 Department of Pediatrics, St Joseph's Hospital, Paterson, NJ Intracranial hemorrhage (ICH) is a rare but devastating complication of childhood immune thrombocytopenia purpura (ITP). A survey of ICH from 1987 to 2000 identified cases of ICH in childhood ITP in the United States. Forty patients with ICH and 80 matched ITP control subjects were accrued. The estimated incidence of ICH was 0.19% to 0.78%. Platelet counts were less than 20 x 109/L in 90% and less than 10 x 109/L in 75% of children with ICH. Eighteen (45%) children developed ICH within 7 days of diagnosis of ITP; for 10 of these, ICH was the presenting feature of ITP. Twelve (30%) children had chronic ITP. Head trauma and hematuria were the most prominent features associated with ICH, identified in 33% and 22.5% of the patients with ICH and 1 and none of the controls (both P < .001). Bleeding beyond petechiae and ecchymoses was also linked to ICH. Mortality was 25%; a further 25% had neurologic sequelae. Strategies by which high-risk children could be identified were considered, and the costs of preventive combination treatment were estimated. Children with severe thrombocytopenia plus head trauma and/or hematuria appeared to be at particularly high risk of ICH. Aggressive treatment of these children may be appropriate. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? Related Article in Blood Online: Childhood ITP: knowing when to worry? Michele P. Lambert Blood 2009 114: 4758-4759. [Full Text] [PDF] This article has been cited by other articles: A. Villella Intracranial Hemorrhage in Children With ITP AAP Grand Rounds, February 1, 2010; 23(2): 19 - 19. [Full Text] [PDF] Intracranial Bleeding in Childhood ITP Journal Watch Oncology and Hematology, January 5, 2010; 2010(105): 3 - 3. [Full Text] M. P. Lambert Childhood ITP: knowing when to worry? Blood, November 26, 2009; 114(23): 4758 - 4759. [Full Text] [PDF]

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