IDIOPATHIC THROMBOCYTOPENIA PURPURA (ITP)

IDIOPATHIC THROMBOCYTOPENIA PURPURA (ITP)


IDIOPATHIC/IMMUNE THROMBOCYTOPENIA PURPURA

  • ITP is an immunological destruction of platelets.
  • It is of 2 types-

a) Acute

b) Chronic

 

a) Acute ITP-

  • It is a self limited disorder.
  • Mostly seen in children after viral infection or upper respiratory illness.
  • It is due to formation of immune complexes containing viral antigens & forming antibodies against platelets.
  • Recovery occurs within 6months spontaneously.

b) Chronic ITP-

  • More common in adults mainly in females (20- 40 years)
  • Associated with SLE, AIDS, autoimmune thyroiditis.
  • Splenomegaly & hepatomegaly are seen.

Pathogenesis-

  • Formation of anti- platelet auntoantibodies usually by IgG humoral antibodies synthesized in spleen.
  • Antibodies against platelets (glycoprotein IIb/ IIIa or Ib/ IX complexes)

 Clinical features-

  • Petechial hemorrhage, bruising
  • Menorrhagia in women
  • Nasal bleeding, bleeding from gums, melaena & hematuria

Investigations-

  • Platelet count is decreased
  • Blood film- megathrombocytes
  • Bone marrow- increased megakaryocytes
  • Serum- IgG antibody
  • Coomb’s test is positive

Treatment-

  • Oral prednisolone- severe purpura, bruising, epitaxis
  • I.V. IgG for increasing platelet count
  • Corticosteroid therapy & immunosuppressive drugs are used
  • Platelet transfusion
  • Splenectomy in chronic ITP can be choice of treatment.

Exam Important

a) Acute ITP-

  • It is a self limited disorder.
  • Mostly seen in children after viral infection or upper respiratory illness.
  • It is due to formation of immune complexes containing viral antigens & forming antibodies against platelets.
  • Recovery occurs within 6months spontaneously.

b) Chronic ITP-

  • More common in adults mainly in females (20- 40 years)
  • Associated with SLE, AIDS, autoimmune thyroiditis.
  • Splenomegaly & hepatomegaly are seen.

Pathogenesis-

  • Formation of anti- platelet auntoantibodies usually by IgG humoral antibodies synthesized in spleen.
  • Antibodies against platelets (glycoprotein IIb/ IIIa or Ib/ IX complexes)
Investigations-

  • Platelet count is decreased
  • Blood film- megathrombocytes
  • Bone marrow- increased megakaryocytes
  • Serum- IgG antibody
  • Coomb’s test is positive
Treatment-
  • Splenectomy in chronic ITP can be choice of treatment.
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