Immune thrombocytopenic pupura (ITP)

Question 1

WTF is it?

Answer 1

Anti-platelet antibodies

Question 2

Presentation

Answer 2

Acute - children, 2 weeks after viral infection with sudden self-limiting purpura
Chronic - (mainly women), fluctuating course: bleeding, purpura (pressure areas), epistaxis, menorrhagia. NO splenomegaly

Question 3

Ix

Answer 3

Bloods: increased megakaryocytes in marrow, anti-platelet Ab

Question 4

Management

Answer 4

Meds:

• None if mild
• Prednisone 1mg/kg/d if plt < 20
• Splenectomy cures 80% if relapses
• immunosuppression: azathioprine, cyclophosphamide

Other: 
platelet transfusion (only for life threatening bleed or splenectomy as pt destroys them so fast) 
IVIg may temporarily raise Plts