The differential diagnosis of purpura in children depends about two considerations: (1) Does the patient look ill? and (2) What is the platelet count?
Here’s how it goes:
| Appearance | Platelet Count | Causes |
| Sick | Low | Meningococcemia, Leukemia, DIC, Hemolytic-Uremic Syndrome (HUS) |
| Sick | Normal or High | (*) Viremia (e.g., EBV), Vasculitis (e.g., Mucocutaneous lymph node syndrome [Kawasaki]) |
| Well | Low | Immune Thrombocytopenic Purpura (ITP), Wiscott-Aldrich, Aplastic anemia |
| Well-ish | Normal | Henoch–Schönlein purpura, Vomiting or coughing (if in SVC distribution) |
| (*) But still always consider meningococcemia in any sick child with purpura, with or without thrombocytopenia! | ||
| Reference: Oxford Handbook of Clinical Specialties, 9e (2013). | ||
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