What are your indications for pursuing a rheumatologic workup in a pediatric patient with ITP?

In regard to pediatric ITP patients and a rheumatologic workup, first, there is no data comparing pediatric ITP patients of all ages and both genders as to the exact rates of positivity and the implications of the positivity in any group.

Having said that, there is some consensus that adolescent females are the ones in whom rheumatologic disease is the most frequent. They are the primary patients in whom testing might be reasonable even without symptoms.

Two issues to consider further:

1. What lev...