Severe hemorrhages in children with chronic idiopathic thrombocytopenic purpura

Idiopathic thrombocytopenic purpura, an immune-mediated disease, usually has a relatively benign clinical course. Bleeding symptoms are usually mucocutaneous and mild. Massive hemorrhages requiring transfusions or other interventions are rare. We report three cases of female children with chronic idiopathic thrombocytopenic purpura, who had severe hemorrhage. Two children had hemoperitoneum following a rupted ovarian cyst. A child had intracranial hemorrhage. These episodes are peculiar because they occurred some years after the onset of thrombocytopenia and in a period of apparent wellbeing.