The nontreatment of childhood idiopathic thrombocytopenic purpura.

Despite the sudden and often alarming clinical manifestations of ITP, few patients in the pediatric age group develop serious complications or long-term sequellae. Conservative therapy, without use of pharmacologic or surgical intervention, is the most convenient, safe, and cost-effective approach in the vast majority of patients. There is a definite role for corticosteroids and IV gamma globulin in certain selected patients with both acute and chronic forms of ITP. Splenectomy may be of value in some chronically affected patients. Other forms of treatment are rarely if ever indicated. In summary, the best therapy for most children with ITP is no treatment at all.