Immune thrombocytopenic purpura

Question 1

What is ITP?

Answer 1

Autoimmune -> reduction in number of circulating platelets

Question 2

What is the pathology underlying ITP?

Answer 2

Type 2 hypersensitivity reaction
Spleen produces antibodies directed against IIb/IIIa or Ib-V-IX complexes

Question 3

What is the key epidemiology of ITP?

Answer 3

Average age of 6 ish yrs
Self limiting
Follows a viral infection
More common in girls

Question 4

What can cause secondary ITP?

Answer 4

Autoimmune - SLE
Infections - H.pylori and CMV
Medications
Lymphoproliferative disorders

Question 5

What are the key signs and symptoms of ITP?

Answer 5

Easb bruising (purpura)
Superficial bleeds on legs (Petechiae)
Prolonged bleeding from cuts
Gums or nose bleeding
Blood in urine or stools
Heavy menstraul flow in females

Question 6

What are the key investigations for ITP?

Answer 6

FBC
Blood film
Inflammatory markers for active infection

Question 7

What is the typical management plan for ITP?

Answer 7

Conservative - watch and wait
TXA - menorrhagia
Persistent cases steroids for 4-7days
IVIG if required
Splenectomy is refractory over 12-24m

Avoid ibuprofen