Table 2.

History and physical findings not consistent with immune thrombocytopenic purpura (ITP) of childhood.

History/FindingsAlternative Diagnosis
Thrombocytopenia present from birth Amegakaryocytosis
 Primary thrombocytopenia
 Giant platelet syndromes 
Weight loss and recurrent fevers Malignancy, immune deficiencies 
Bloody diarrhea Wiskott Aldrich
 Hemolytic uremic syndrome 
Recurrent infections or failure to thrive Primary immune disorder, HIV 
History or presence of jaundice Autoimmune hemolytic disease
 Hepatitis, cirrhosis with splenomegaly 
Splenomegaly, lymphadenopathy Autoimmune lymphoproliferative syndrome (ALPS), primary immune disorders, Gauchers malignancies, hypersplenism syndromes 
Forearm or hand anomalies Thrombocytopenia absent radii (TAR)
 Fanconi’s syndrome 
Malar rash, dermatomyocytis, polymyocytis, eczema Collagen vascular disease, Wiskott Aldrich 
Cardiac malformation with or without DiGeorge syndrome Chromosome 22 microdeletions with large platelets, with or without Evans syndrome 
History/FindingsAlternative Diagnosis
Thrombocytopenia present from birth Amegakaryocytosis
 Primary thrombocytopenia
 Giant platelet syndromes 
Weight loss and recurrent fevers Malignancy, immune deficiencies 
Bloody diarrhea Wiskott Aldrich
 Hemolytic uremic syndrome 
Recurrent infections or failure to thrive Primary immune disorder, HIV 
History or presence of jaundice Autoimmune hemolytic disease
 Hepatitis, cirrhosis with splenomegaly 
Splenomegaly, lymphadenopathy Autoimmune lymphoproliferative syndrome (ALPS), primary immune disorders, Gauchers malignancies, hypersplenism syndromes 
Forearm or hand anomalies Thrombocytopenia absent radii (TAR)
 Fanconi’s syndrome 
Malar rash, dermatomyocytis, polymyocytis, eczema Collagen vascular disease, Wiskott Aldrich 
Cardiac malformation with or without DiGeorge syndrome Chromosome 22 microdeletions with large platelets, with or without Evans syndrome 

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