Immune thrombocytopenia purpura

Question 1

What is ITP?

Answer 1

Immune mediated reduction in platelet count

Question 2

How can ITP occur in children?

Answer 2

Following an infection or vaccination.

Question 3

What type of condition is it usually in children?

Answer 3

self-limitiing

Question 4

What type of condition is it usually in adults?

Answer 4

Chronic relapsing disease

Question 5

How can ITP be diagnosed?

Answer 5

Incidentally following routine bloods

Question 6

What are the main presenting features of ITP?

Answer 6

petechiae, purpura
bleeding (e.g. epistaxis)

Question 7

What investigations can be done for ITP?

Answer 7

full blood count
blood film

Question 8

What might you find in a FBC in someone with ITP?

Answer 8

Isolated thrombocytopenia

Question 9

What is the first line medical managment of ITP?

Answer 9

Oral prednisolone

Question 10

Why is medical management not always used in patients presenting with ITP?

Answer 10

85% of cases spontaneously remit in 3-6 months so a watch and wait approach is generally advised.

Question 11

What other medical management can be used in someone with ITP?

Answer 11

Human immunoglobulin (IVIG)

Question 12

What is an advantage of IVIG over steroids?

Answer 12

It raises the platelet count quicker than steroids

Question 13

When would you use IVIG over steroids in someone with ITP?

Answer 13

Active bleeding or an urgent invasive procedure is required

Question 14

What will be increased in someone with ITP?

Answer 14

Bleeding time

Question 15

What might you see on a peripheral blood smear in someone with ITP?

Answer 15

True thrombocytopenia

Question 16

When would you give steroids for ITP?

Answer 16

Platelet count <30*109/L

Question 17

When would you implement a watch and wait management of ITP?

Answer 17

Platelet count >30*109/L