Mucosal bleeding alone (if self-limited), like cutaneous bleeding, is not an indication for treatment. The indication for steroid therapy in children with ITP is *severe* bleeding. See the following per AMBOSS:
"Currently, the American Society of Hematology only recommends corticosteroid therapy for pediatric patients with ITP who present with severe bleeding (e.g., prolonged epistaxis, bleeding from the gastrointestinal tract, intracranial hemorrhage). Therefore, self-limited epistaxis and isolated petechiae, as seen in this patient, are not indications for corticosteroid therapy."
Additionally, the extra field should not say that no bleeding and plt >30,000 is an indication for observation because in children, pharm intervention is based only on clinical presentation:
"Unlike in children, in whom the indication for pharmacological intervention is based exclusively on clinical presentation, treatment initiation is generally recommended in adults with ITP with a platelet count < 30,000/mm3."
