Charlie was two years old when he started coming back from nursery school with big bruises in awkward places such as his mid-back or on his ribs.

In Malta there have been several cases of acute ITP, which clears up after six months. There are only four children – including Charlie – suffering from chronic ITP

His parents were concerned: What was going on? Was he constantly falling over?

No, the teacher said, he was not being overly active and she immediately recommended to his parents that they seek immediate medical advice as spontaneous bruising could be a sign of a serious medical condition.

“That was the first shock. We were thinking leukemia,” said Alicia Crabbe, Charlie’s mother, from Rabat.

They rushed to paediatrician Gisella Fenech, who immediately recognised the symptoms: “It’s probably ITP,” she told them before sending them to Mater Dei Hospital to have his blood tested.

At Mater Dei, a bone marrow biopsy ruled out leukemia. “This was a relief but, of course, we had never heard of ITP before, so we were still fazed.”

ITP, they soon learnt, stands for idiopathic thrombocytopenic purpura. Idiopathic means of unknown cause and purpura means bruising.

It is a disorder in which the body’s immune system destroys platelets in the blood. Blood platelets are small and sticky and their job is to prevent bruising and stop bleeding after an injury.

“Basically, Charlie’s immune system thinks that his platelets are foreign bodies and, therefore, attacks and destroys them,” explained Mrs Crabbe.

As a consequence, because they don’t have enough platelets, ITP sufferers are prone to “easy bruising” following minor knocks. The major fear is some potentially serious spontaneous bleeding occurring in internal organs or the brain.

Charlie, like most people with ITP disorder, is never really in pain but he has to be cautious: “If he’s playing and he falls and bangs his head we have to rush off to hospital for a brain scan,” said Mrs Crabbe.

The lower the blood platelet count, the higher the risk of serious bleeding and Charlie’s is extremely low.

There is, as yet, no direct treatment for this disorder.

Doctors gave Charlie’s parents choices about any possible treatments and initially Charlie was on steroids: “But these only temporarily raise the platelet count and do not cure the disease, so in the end we decided to stop them as the side-effects were causing him pain,” said Malcolm Crabbe, the father.

According to Dr Fenech, in Malta there have been several cases of acute ITP, which clears up after six months. ­However, there are only four children – including Charlie – suffering from chronic ITP.

Internationally, about four in every 100,000 children develop ITP each year. “After the first six months we kept hoping that he would get better but Charlie’s is five now. He’s had it for two and a half years. We are hoping his immune system will correct itself but we have no idea when this might be, if at all,” said Mrs Crabbe.

They are very much aware that as Charlie grows older, ITP will restrict his activities more: “He has to avoid any contact sports like skiing, rugby, even football,” said Mr Crabbe.

Long haul flights are also out: “My sister lives in India and there’s no way we can go and visit her because we are not sure yet if exposure to cabin pressure for long hours affects ITP,” said Mrs Crabbe.

Also, they need to make sure that wherever they go they are within reach of good hospitals.

So far they have only travelled to the UK, their home country. The family had just moved to Malta from the UK nine months before Charlie’s diagnosis and were still finding their feet here when they became frequent visitors to Mater Dei.

However, they never thought of seeking treatment in the UK: “We are very happy with the service at Mater Dei. We believe we get a more personal service here than we would have in the UK,” said Mr Crabbe.

As there is no ITP support group in Malta, the Crabbes became members of the ITP Support Association in the UK and regularly hold fund raising activities for the association to fund clinical research to try to discover the possible causes of ITP, who is at risk of it and to identify its most effective treatments.

It is not yet known what triggers ITP, what is certain is that it cannot be caught or passed on. According to the ITP Support Association it can follow some vaccinations or some simple viral infection. “In Charlie’s case, it could have been triggered by the cold virus he had a few weeks before we noticed his first bruises,” his parents said.

How does Charlie cope with it? “We’ve always talked about it with him and he knows that if he has a bad bang, even at school, he has to tell his teacher, because we have to take him to hospital,” she said.

What he dislikes is the stares that he gets from people when he has bruises or black eyes. “You can hear people whispering behind us sometimes or they actually come up to us to see if he’s okay. It upsets Charlie because he is a shy boy and he hates to draw people’s attention,” she said.

More information about ITP and how to donate towards its research on www.itpsupport.org.uk.