Immune thrombocytopenia Purpura

Question 1

Define:

Answer 1

Syndrome characterised by immune destruction of platelets resulting in bleeding or bruising tendency

Question 2

Aetiology:

Answer 2

Autoantibodies against the GpIIb/IIIa receptors on platelets

Often idiopathic

Acute usually in children following a viral infection

Question 3

What is ITP associated with:

Answer 3

Autoimmune conditions (SLE and thyroid)
Infections (HIV, EBV and malaria)
Malignancies
Drugs

Question 4

Epidemiology:

Answer 4

Acute in children aged 2-7years

Chronic in adults - 4x more in females

Question 5

Symptoms:

Answer 5

Easy bruising
Epistaxis
Menorrhagia
Mucousal bleeding

Question 6

Signs:

Answer 6

Petechiae or bruising

Signs of the underlying cause

Question 7

Investigations:

Answer 7

Diagnosis of exclusion. Must exlcude:

• Myelodysplasia
• Acute leukaemia
• Marrow infiltration

FBC - low platelets
Clotting screen - normal APTT, PT and fibrinogen
Autoantibodies

Blood films - rule out pancytopenia

Bone marrow