What is the differential diagnosis for purpura in children?

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Last updated: February 9, 2025View editorial policy

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Differential Diagnosis for Purpura in Kids

Single Most Likely Diagnosis

  • Idiopathic Thrombocytopenic Purpura (ITP): This is the most common cause of purpura in children, characterized by isolated thrombocytopenia without other underlying conditions. It often presents with sudden onset of petechiae, purpura, and sometimes bleeding.

Other Likely Diagnoses

  • Infection-related purpura: Certain infections, such as meningococcemia, can cause purpura. The presence of fever, rash, and other systemic symptoms may suggest an infectious etiology.
  • Henoch-Schönlein Purpura (HSP): A form of vasculitis that affects small blood vessels, HSP is characterized by palpable purpura, abdominal pain, and arthritis. It is more common in children and often follows a respiratory infection.
  • Trauma: Accidental or non-accidental trauma can cause purpura, especially in infants and young children.

Do Not Miss Diagnoses

  • Meningococcemia: A life-threatening infection caused by Neisseria meningitidis, characterized by purpura, fever, and shock. Prompt recognition and treatment are crucial to prevent mortality.
  • Disseminated Intravascular Coagulation (DIC): A condition characterized by both clotting and bleeding, DIC can cause purpura, petechiae, and other bleeding manifestations. It is often associated with severe underlying conditions, such as sepsis or trauma.
  • Leukemia: Certain types of leukemia, such as acute lymphoblastic leukemia (ALL), can present with purpura, petechiae, and other signs of bone marrow failure.

Rare Diagnoses

  • Congenital coagulopathies: Rare genetic disorders, such as hemophilia or von Willebrand disease, can cause purpura and other bleeding manifestations.
  • Vasculitis: Other forms of vasculitis, such as Kawasaki disease or polyarteritis nodosa, can cause purpura and other systemic symptoms.
  • Thrombotic thrombocytopenic purpura (TTP): A rare disorder characterized by thrombocytopenia, microangiopathic hemolytic anemia, and other systemic symptoms.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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