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Immune Thrombocytopenia Purpura (ITP) (Clinical Presentation (Purpura (red…
Immune Thrombocytopenia Purpura (ITP)
Key Facts
The antibody-coated platelets are removed following binding to Fc receptors on macrophages
IgG antibodies form to platelets and megakaryocytes
Thrombocytopenia is due to immune destruction of platelets
Clinical Presentation
Purpura (red or purple spots on the skin caused by bleeding underneath skin)
Gum bleeding
Menorrhagia (heavy menstruation)
Major haemorrhage is rare
Epistaxis (nose bleed)
Splenomegaly is rare
Easy bruising
Diagnosis
Bone marrow examination
Shows thrombocytopenia with increased or normal megakaryocytes in the marrow
Platelet autoantibodies - not needed for diagnosis
Treatment
First line
Corticosteroids
IV immunoglobulin - raises platelet count more rapidly than steroids - thus useful for surgery
Second line
Splenectomy
If splenectomy fails then immunosuppression