Idiopathic thrombocytopenic purpura (ITP)
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Idiopathic thrombocytopenic purpura is the autoimmune disorder characterized by pronounced decreased in circulating platelets due to auto antiplatelet antibody with a resultant bleeding diathesis.
ITP is more common on children and female. Clinically it presents with the bleeding diathesis such as petchiae, ecchymoses, hematomas which appear either spontaneous or minor trauma or in minor operation. Patient can also be present with the intestine, urinary bleeding or menorrhagia in females. Large hematomas and hemarthrosis are usually uncommon.
In spite of hypersplenism there is no splenomegaly in ITP.
Diagnosis of ITP is done by taking complete history, physical examination, blood test (decreased platelets count, decreased hemoglobin, and increased bleeding time) and Rumple Leeds test (Petchiae are produced distal to sphygmomanometer cuff inflated above venous pressure).
Initially patient is managed with steroids or by intravenous immunoglobulin if there is no bleeding. When platelets count is less than 50000 or less than 80000 which need major operation is managed with fresh blood or fresh frozen plasma which stops the bleeding temporarily.
Splenectomy is indicated if remission is not achieved or if the disease exacerbates while under steroid). Splenectomy is curative in about three fourth of patients of ITP.
Filed Under: Hematology
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