ITP

Question 1

What is ITP?

Answer 1

immune-mediated reduction in the platelet count

Question 2

What are Antibodies directed against in ITP?

Answer 2

glycoprotein IIb/IIIa or Ib-V-IX complex.

Question 3

Describe the difference in ITP presentation between children and adults

Answer 3

Children = acute thrombocytopenia that may follow infection or vaccination

Adults = more chronic condition.

Question 4

In what demographic is ITP more common?

Answer 4

Older females

Question 5

How do patients present with ITP?

Answer 5

Asymptomatic - seen on routine bloods

symptomatic:
- petechiae
- purpura
- bleeding (e.g. epistaxis)
- catastrophic bleeding (e.g. intracranial)

Question 6

Investigations to confirm ITP

Answer 6

FBC: thrombocytopenia
Blood film

antiplatelet antibody testing has poor sensitivity

Question 7

Management of ITP

Answer 7

• oral prednisolone
• IV Immunoglobulin (Ig)
• immunosuppressive drugs e.g. cyclophosphamide/MMF
• splenectomy is now less commonly used

Question 8

What is Evans syndrome?

Answer 8

ITP in association with autoimmune haemolytic anaemia (AIHA)