User:Mr. Ibrahem/Immune 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[1] |
Complications | Intracranial bleeding[1] |
Types | Acute, chronic[2] |
Risk factors | Post infection, autoimmune disease[1] |
Diagnostic method | Platelets < 100 x 109/L, normal WBCs, normal RBCs[1] |
Differential diagnosis | Leukemia, autoimmune hemolytic anemia, thrombotic thrombocytopenic purpura, hemolytic uremic syndrome[1] |
Treatment | None, medications, surgery to remove the spleen[1] |
Frequency | 3 per 100,000 new cases per year[1] |
Immune thrombocytopenic purpura (ITP), also known as idiopathic thrombocytopenic purpura, is low platelets with generally normal white blood cells and red blood cells.[1] Symptoms may include bleeding into the skin, resulting in purpura (purple bruises) or petechiae (small red dots) or bleeding gums.[1] Less commonly more seriously bleeding, such as intracranial bleeding, may occur.[1]
The underlying mechanism typically involves autoantibodies against platelet membrane proteins.[1] 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.[1][2] Diagnosis is by finding a platelet level of less than 100 x 109/L (100,000/mm3).[1] Sometimes the remaining platelets may be abnormally large.[1] A bone marrow biopsy is generally not needed.[1]
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.[1] Up to 70% of children will get better within six months.[1] For more significant cases corticosteroids, intravenous immunoglobulin, or anti-D immunoglobulin may be used.[1] In those who do not respond to these treatments eltrombopag or romiplostim may be used.[1] Surgery to remove the spleen may also occasionally be required.[1]
About 3 per 100,000 people are newly affected a year.[1] Rates are similar in children and adults.[1] The acute form more commonly occurs in children while the chronic form more commonly occurs in adults.[2] In earliest description of a case that fits with ITP is from 1025 by Avicenna.[3]
References[edit]
- ^ a b c d e f g h i j k l m n o p q r s t u v Pietras, NM; Pearson-Shaver, AL (January 2020). "Immune Thrombocytopenic Purpura". PMID 32965953.
{{cite journal}}
: Cite journal requires|journal=
(help) - ^ a b c Justiz Vaillant, AA; Gupta, N (January 2020). "ITP-Immune Thrombocytopenic Purpura". PMID 30725925.
{{cite journal}}
: Cite journal requires|journal=
(help) - ^ Stasi R, Newland AC (May 2011). "ITP: a historical perspective". Br. J. Haematol. 153 (4): 437–50. doi:10.1111/j.1365-2141.2010.08562.x. PMID 21466538.