Primary immune thrombocytopenia (ITP) is an autoimmune condition characterized by immune-mediated platelet destruction combined with impaired platelet production in the bone marrow that results in thrombocytopenia and a bleeding tendency. 1,2 Primary ITP is defined as a platelet (PLT) count <100 × 10 9 /L in the absence of underlying causes, with an estimated incidence of 4.2 per 100 000 person-years 2-4 ; and is the most common cause of thrombocytopenia in children. ITP is mostly a selflimiting process for most of paediatric patients; 5,6 hence, a watch-and-wait policy is generally recommended for incident paediatric cases of ITP. However, it may become chronic in up to 20% of patients. [7][8][9] Paediatric chronic ITP is commonly associated with limited activities and fear of bleeding that can obviously affect the quality of life. 10

Immune thrombocytopenia (ITP) is an acquired immune disorder characterized by reduced platelet (Plt) production and increased platelet destruction, which increases bleeding risk, with a prevalence of 5 in 100 000 children. 1,2 Although it does have a high rate of spontaneous remission, 30%-40% of cases of persistent or chronic immune thrombocytopenia (p/cITP) lead to heavy bleeding. 3,4 Thrombopoietin receptor agonists (TRAs) have emerged as the best treatment to elevate and maintain the Plt count for children with p/cITP. [5][6][7] Eltrombopag (ELT) increases

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