User:Mr. Ibrahem/Immune thrombocytopenic purpura

Not to be confused with Autoimmune thrombotic thrombocytopenic purpura.

Mr. Ibrahem/Immune thrombocytopenic purpura
Other names	Idiopathic thrombocytopenic purpura, idiopathic immune thrombocytopenia, primary immune thrombocytopenia, idiopathic thrombocytopenic purpura, primary immune thrombocytopenic purpura, autoimmune thrombocytopenic purpura
Petechiae, or small bruise-like markings, may occur in ITP
Specialty	Hematology
Symptoms	Purple bruises, small red dots in the skin, bleeding gums
Complications	Intracranial bleeding
Types	Acute, chronic
Risk factors	Post infection, autoimmune disease
Diagnostic method	Platelets < 100 x 109/L, normal WBCs, normal RBCs
Differential diagnosis	Leukemia, autoimmune hemolytic anemia, thrombotic thrombocytopenic purpura, hemolytic uremic syndrome
Treatment	None, medications, surgery to remove the spleen
Frequency	3 per 100,000 new cases per year

Immune thrombocytopenic purpura (ITP), also known as idiopathic thrombocytopenic purpura, is low platelets with generally normal white blood cells and red blood cells. Symptoms may include bleeding into the skin, resulting in purpura (purple bruises) or petechiae (small red dots) or bleeding gums. Less commonly more seriously bleeding, such as intracranial bleeding, may occur.

The underlying mechanism typically involves autoantibodies against platelet membrane proteins. This is typically triggered by an infection such as hepatitis C, cytomegalovirus, or varicella zoster, an autoimmune disease such as lupus, a cancer such as chronic lymphocytic leukemia or lymphoma, or certain medications. Diagnosis is by finding a platelet level of less than 100 x 10⁹/L (100,000/mm³). Sometimes the remaining platelets may be abnormally large. A bone marrow biopsy is generally not needed.

In adults with platelets of more than 30 x 10⁹/L and children at all platelet levels, who have only mild bleeding, careful observation is generally all that is required. Up to 70% of children will get better within six months. For more significant cases corticosteroids, intravenous immunoglobulin, or anti-D immunoglobulin may be used. In those who do not respond to these treatments eltrombopag or romiplostim may be used. Surgery to remove the spleen may also occasionally be required.

About 3 per 100,000 people are newly affected a year. Rates are similar in children and adults. The acute form more commonly occurs in children while the chronic form more commonly occurs in adults. In earliest description of a case that fits with ITP is from 1025 by Avicenna.