ITP

Idiopathic (Immune) Thrombocytopenic Purpura

Thrombocytopenia in the absence of other blood cell abnormalities (normal RBC & WBC, normal peripheral smear)

ITP 2 types-acute/chronic In children the commonly seen type

is acute ITP Follows vaccination or viral ifection

Pathogenesis Ab produced against pltlets Ab bound platelets are removed and

destroyed by the RES-spleen and liver

This cause thrombocytopenia

Clinical Manifestations May be acute or insidious onset Mucocutaneous Bleeding *petechiae, purpura, ecchymosis *epistaxis, gum bleeding *menorrhagia *GI bleed, CNS bleed = RARE

Diagnosis (of Exclusion) Rule out other causes:

Management of ITP

Goal = prevention of bleeding, NOT cure!

in many children ITP resolves spontaneously(10% end as chronic ITP)

General Mx Avoid contact sports Avoid NSAIDS Avoid IM injections Beware of signs of major bleed –

headache,LOC in ICH

Tx Usually no Tx needed Tx if pltlet low than 10000 or

major bleed -Prednisone-IvIg

Splenectomy in non resolving cases