Diagnosis:
Immune thrombocytopenia purpura
• Immune thrombocytopenia (ITP) is the most likely cause of isolated thrombocytopenia in an otherwise healthy patient.
• It is defined as an isolated platelet count less than 100 × 109/L.
• Patients may present with petechiae/purpura, bruising, or mucosal bleeding, but many patients are asymptomatic.
• ITP is due to accelerated destruction of platelets by antiplatelet antibodies. There is increased clearance of antibody-coated platelets by the spleen.
• Additionally, there is evidence of decreased production of platelets by megakaryocytes in the bone marrow.
• Corticosteroids, intravenous immunoglobulin, and anti-Rho(D) immune globulin (WinRho) are the first-line agents for the treatment of ITP.
• Splenectomy, rituximab, and thrombopoietin receptor agonists are second-line therapies.
• In the absence of severe bleeding, ITP is considered a relative contraindication for platelet transfusion since the patient’s antiplatelet antibodies will rapidly clear the transfused platelets.
