Immune thrombocytopenic purpura

Clinic

• Also known as idiopathic thrombocytopenic purpura or immune thrombocytopenia,
• ITP is a type of thrombocytopenic purpura defined as an isolated low platelet count with a normal bone marrow in the absence of other causes of low platelets.

• ITP is an autoimmune disease with antibodies detectable against several platelet surface structures.
• Its serious and possibly fatal complications include subarachnoid or intracerebral hemorrhage, lower gastrointestinal bleeding or other internal bleeding
• In approximately 60 % of cases, antibodies against platelets can be detected.

Researches

• Chronic immune thrombocytopenic purpura (CITP) is secondary to other underlying disorders.
• Chronic infection with HIV and HCV are now well-characterized causes of CITP.

Related disease

• Thrombotic thrombocytopenic purpura
• Thrombocytopenia

Miasms

B19

HCV

HIV

ITP is diagnosed by identifying a low platelet count on a complete blood count (a common blood test). However, since the diagnosis depends on the exclusion of other causes of a low platelet count, additional investigations (such as a bone marrow biopsy) may be necessary in some cases.

In mild cases, only careful observation may be required but very low counts or significant bleeding may prompt treatment with corticosteroids, intravenous immunoglobulin, anti-D immunoglobulin, or immunosuppressive medications. Refractory ITP (not responsive to conventional treatment or constant relapsing after splenectomy) requires treatment to reduce the risk of clinically significant bleeding. Platelet transfusions may be used in severe cases with very low platelet counts in people who are bleeding. Sometimes the body may compensate by making abnormally large platelets.

Signs and symptoms[edit]

Signs include the spontaneous formation of bruises (purpura) and petechiae (tiny bruises), especially on the extremities, bleeding from the nostrils and/or gums, and menorrhagia (excessive menstrual bleeding), any of which may occur if the platelet count is below 20,000 per μl. A very low count (<10,000 per μl) may result in the spontaneous formation of hematomas (blood masses) in the mouth or on other mucous membranes. Bleeding time from minor lacerations or abrasions is usually prolonged.^{[citation needed]}