Idiopathic Thrombocytopenic Purpura Follow-up
- Author: Michael A Silverman, MD, MD; Chief Editor: Gil Z Shlamovitz, MD, FACEP more...
Further Outpatient Care
See the list below:
- Close follow-up care with a hematologist is required.
- Elective splenectomy may be necessary if medical therapy fails.
Further Inpatient Care
See the list below:
- Rule out other potential causes of thrombocytopenia.
- Emergency splenectomy may be necessary if severe bleeding complications due to thrombocytopenia do not respond to medical therapy.
- Observe for life-threatening bleeding.
- Consult with a hematologist, as further treatments (eg, steroids, IVIg, platelet transfusion) may be indicated.
Transfer may be necessary under the following conditions:
- A hematologist is not available.
- Blood bank support is insufficient.
- A higher level of intensive care is needed.
Complications of idiopathic thrombocytopenic purpura may include the following:
- Intracranial or other major hemorrhage
- Severe blood loss
- Adverse effects of corticosteroids
- Pneumococcal infections if the patient must have a splenectomy
Approximately 83% of children have a spontaneous remission, and 89% of children eventually recover. More than 50% recover within 4-8 weeks. Approximately 2% die.
Only 2% of adults have a spontaneous recovery; however, approximately 64% of adults eventually recover. Approximately 30% have chronic disease, and 5% die from hemorrhage.
See the list below:
- Instruct patients to return for follow-up in order to assess for a potentially reduced platelet count.
- Emphasize close outpatient follow-up care.
- Because of the increased risk of bleeding, instruct patients to avoid aspirin products.
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