Immune thrombocytopenia - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Immune thrombocytopenia (ITP) in children typically presents with a preceding viral illness and an abrupt onset. There is a female preponderance among adults, who may present with thrombocytopenia with or without bleeding.
Petechiae occur primarily on the lower limbs, but can appear anywhere on the body (including mucosal membranes), particularly if thrombocytopenia is severe. Bruising is common. Mucosal bleeding may also occur in more severe cases. Intracranial bleeding is reported in approximately 0.5% of children and 1.5% of adults.
Complete blood count and peripheral blood smear show isolated thrombocytopenia.
Treatment is based on platelet count and bleeding symptoms. Patients with life-threatening bleeding, regardless of platelet count, can be considered for combination therapy with corticosteroids, intravenous immune globulin (IVIG), and platelet transfusion.
Initial treatment options for newly diagnosed ITP include observation, or a corticosteroid and/or IVIG depending on platelet count and bleeding symptoms. Intravenous Rho(D) immune globulin can be considered in patients who are rhesus-positive and nonsplenectomized.

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Definition

Epidemiology

Etiology

Pathophysiology

Citations

Key Articles

Rodeghiero F, Stasi R, Gernsheimer T, et al. Standardization of terminology, definitions and outcome criteria in immune thrombocytopenic purpura of adults and children: report from an international working group. Blood. 2009 Mar 12;113(11):2386-93.[Abstract][Full Text]
Provan D, Arnold DM, Bussel JB, et al. Updated international consensus report on the investigation and management of primary immune thrombocytopenia. Blood Adv. 2019 Nov 26;3(22):3780-817.[Abstract][Full Text]
Neunert C, Terrell DR, Arnold DM, et al. American Society of Hematology 2019 guidelines for immune thrombocytopenia. Blood Adv. 2019 Dec 10;3(23):3829-66.[Abstract][Full Text]

Referenced Articles

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