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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes swollen lip in a child suffering from ITP?

Dear Sir, 1. My 4 yrs Son was Diagnosed with acute ITP 3 weeks back since he had some rashes in legs(Plt count had gone down to 7000). IVIG was given @ 2 gms / KG. count went up to 36000 then 100000 and then backto 58000.Bone marrow was conducted and ITP confirmed .now is fine no medicines being given yesterday again count carried out it was 48000.Just now his left top lip has swollen,the way it swells when an ant bites,no reddish or clot signs anywhere in mouth or lips.Child does not know whether it is an ant bite or not. my question is can it be due to ITP or a simple ant bite am worried. Now I have been told to wait and watch no medicines.I wanted your opinion PL?
Thu, 21 May 2020
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Pediatrician 's  Response
Hello,

Having a child with ITP is a bit of a roller coaster, isn't it! This may or may not be related to his ITP, but without any visible bleeding, and if the swelling stays the same as usual, then I too would counsel you to just wait and watch. I know that is hard. Most swelling of the skin, especially that caused by minor trauma such as a bug bite, is not actually bleeding but an increase in inflammatory fluids in the superficial layers of the skin. It feels squishy and looks mostly pale. This is not affected by ITP.

Sometimes, swelling seen on the body is really a bruise or bleeding under the skin. This can be a problem in children with ITP because it is related to bleeding and clotting. In this case, the area should look more like a bruise. But even then, you can help stop the (inside) bleeding by applying gentle pressure. Even with treated ITP and platelets above 20,000, this is usually all you need. In your case, I think you are doing the right thing by waiting and watching.

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Lisa Baker, Pediatrician
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What causes swollen lip in a child suffering from ITP?

Hello, Having a child with ITP is a bit of a roller coaster, isn t it! This may or may not be related to his ITP, but without any visible bleeding, and if the swelling stays the same as usual, then I too would counsel you to just wait and watch. I know that is hard. Most swelling of the skin, especially that caused by minor trauma such as a bug bite, is not actually bleeding but an increase in inflammatory fluids in the superficial layers of the skin. It feels squishy and looks mostly pale. This is not affected by ITP. Sometimes, swelling seen on the body is really a bruise or bleeding under the skin. This can be a problem in children with ITP because it is related to bleeding and clotting. In this case, the area should look more like a bruise. But even then, you can help stop the (inside) bleeding by applying gentle pressure. Even with treated ITP and platelets above 20,000, this is usually all you need. In your case, I think you are doing the right thing by waiting and watching. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Lisa Baker, Pediatrician