Childhood idiopathic thrombocytopenic purpura. Aggressive management of life-threatening complications.

Idiopathic thrombocytopenic purpura (ITP) in childhood is usually a benign, self-limited illness. Life-threatening complications, such as central nervous system (CNS) hemorrhage, occur in less than 1% of cases. We report a case in which the patient failed to respond to splenectomy and high-dose corticosteroid therapy. Immunosuppressive therapy with cyclophosphamide, vincristine sulfate, and corticosteroids in conjunction with frequent transfusions of platelets was associated with a complete remission that persisted after therapy was discontinued.