Idiopathic thrombocytopenic purpura (ITP), also known as immune thrombocytopenia, primary immune thrombocytopenia, primary immune thrombocytopenic purpura or autoimmune thrombocytopenic purpura, is defined as isolated low platelet count (thrombocytopenia) with normal bone marrow and the absence of other causes of thrombocytopenia. It causes a characteristic purpuric rash and an increased tendency to bleed. Two distinct clinical syndromes manifest as an acute condition in children and a chronic condition in adults. The acute form often follows an infection and has a spontaneous resolution within 2 months. Chronic idiopathic thrombocytopenic purpura persists longer than 6 months with a specific cause being unknown.
ITP is an autoimmune condition with antibodies detectable against several platelet surface antigens.
ITP is diagnosed by a low platelet count in a complete blood count (a common blood test). However, since the diagnosis depends on the exclusion of other causes of a low platelet count, additional investigations (such as a bone marrow biopsy) may be necessary in some cases.
In mild cases, only careful observation may be required but very low counts or significant bleeding may prompt treatment with corticosteroids, intravenous immunoglobulin, anti-D immunoglobulin, or immunosuppressive drugs.Refractory ITP (not responsive to conventional treatment) may require splenectomy, the surgical removal of the spleen. Platelet transfusions may be used in severe bleeding together with a very low count. Sometimes the body may compensate by making abnormally large platelets.
