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Idiopathic Purpura With Gray Platelets

an Acquired Form of Gray Platelet Syndrome

Lee, Anselm Chi-wai, MBBS, FRCPCH

Journal of Pediatric Hematology/Oncology: January 2019 - Volume 41 - Issue 1 - p 47–50
doi: 10.1097/MPH.0000000000001334
Original Articles

An acquired, transient bleeding disorder that predominantly affects children in Southeast Asia has been reported for the last 4 decades. The condition has been named idiopathic purpura with gray platelets (IPGP) or acquired platelet dysfunction with eosinophilia. In a retrospective review from a private pediatric clinic over an 8-year period, 10 consecutive children were diagnosed as IPGP with a mean age of 8.4 (3.7 to 16.2) years. Eosinophilia (>0.5×109/L) was absent in 1, while gray platelets were consistently found in all cases with a mean proportion of 64.5% (40% to 80%). Platelet aggregation tests were performed in 9 patients with abnormal responses consistent with platelet storage pool defect. All children recovered completely and spontaneously from 1 to 4 months after diagnosis without specific therapy. In an otherwise well child who presents abruptly with easy bruising and a platelet count >100×109/L, IPGP can be readily recognized as an acquired form of gray platelet syndrome. Eosinophilia is common but not mandatory for diagnosis.

Children’s Haematology and Cancer Centre, Mount Elizabeth Hospital, Mount Elizabeth, Singapore

The author declares no conflict of interest.

Reprints: Anselm Chi-wai Lee, MBBS, FRCPCH, Children’s Haematology and Cancer Centre, Mount Elizabeth Hospital, Level 4, 3 Mount Elizabeth, Singapore 228510 (e-mail:

Received April 18, 2018

Accepted September 6, 2018

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