Immune Thrombocytopenic Purpura (ITP) Questions & Answers

Updated: Jun 28, 2019
  • Author: Craig M Kessler, MD, MACP; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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Questions & Answers

Overview

What is immune thrombocytopenic purpura (ITP)?

Which symptoms can be used to exclude a diagnosis of immune thrombocytopenic purpura (ITP)?

Which physical findings indicate the severity of immune thrombocytopenic purpura (ITP)?

Which findings suggest intracranial hemorrhage in immune thrombocytopenic purpura (ITP)?

What is the role of lab testing in the diagnosis of immune thrombocytopenic purpura (ITP)?

What is the role of bone marrow aspiration and biopsy in the diagnosis of immune thrombocytopenic purpura (ITP)?

How is immune thrombocytopenic purpura (ITP) managed?

What are the treatment options for immune thrombocytopenic purpura (ITP)?

How is immune thrombocytopenic purpura (ITP) managed during pregnancy and delivery?

What is immune thrombocytopenic purpura (ITP)?

How is immune thrombocytopenic purpura (ITP) diagnosed?

What is the pathophysiology of immune thrombocytopenic purpura (ITP)?

What causes immune thrombocytopenic purpura (ITP)?

What causes autoantibody stimulation in the pathogenesis of immune thrombocytopenic purpura (ITP)?

Which platelet complex is most commonly involved in the pathogenesis of immune thrombocytopenic purpura (ITP)?

What is the role of the spleen in the pathogenesis of immune thrombocytopenic purpura (ITP)?

How are platelets destroyed in thrombocytopenic purpura (ITP)?

What is the annual incidence of immune thrombocytopenic purpura (ITP) in the US?

What is the global prevalence of immune thrombocytopenic purpura (ITP)?

What is the primary cause of morbidity and mortality in immune thrombocytopenic purpura (ITP)?

What is the cause of treatment-related morbidity in immune thrombocytopenic purpura (ITP)?

How does the prevalence of immune thrombocytopenic purpura (ITP) vary by sex?

How does the incidence of immune thrombocytopenic purpura (ITP) vary by age?

How does the prognosis of immune thrombocytopenic purpura (ITP) vary?

What is the prognosis of immune thrombocytopenic purpura (ITP) in children?

Which factors increase the risk of developing chronic immune thrombocytopenic purpura (ITP)?

Which factors decrease the risk of developing chronic immune thrombocytopenic purpura (ITP)?

What is the prognosis of immune thrombocytopenic purpura (ITP) in adults?

Presentation

What should be the focus of medical history in the evaluation of immune thrombocytopenic purpura (ITP)?

Which systemic illnesses may manifest as immune thrombocytopenic purpura (ITP)?

What history is characteristic of immune thrombocytopenic purpura (ITP) in children?

Which infections may trigger immune thrombocytopenic purpura (ITP)?

What are the manifestations of immune thrombocytopenic purpura (ITP) in patients with HIV infection?

Which medications may cause immune thrombocytopenic purpura (ITP)?

How is drug-induced thrombocytopenia diagnosed?

What is the role of quinidine and quinine in the etiology of immune thrombocytopenic purpura (ITP)?

How should heparin use be assessed in the evaluation of immune thrombocytopenic purpura (ITP)?

Which antiplatelet drugs may cause immune thrombocytopenic purpura (ITP)?

Which types of medications are associated with drug-induced immune thrombocytopenic purpura (ITP)?

How is bleeding tendency assessed in suspected immune thrombocytopenic purpura (ITP)?

What should be the focus of the physical exam for suspected immune thrombocytopenic purpura (ITP)?

Which general health findings are useful in the evaluation of immune thrombocytopenic purpura (ITP)?

Which skin and mucous membrane findings are characteristic of immune thrombocytopenic purpura (ITP)?

Which cardiovascular findings are significant in the evaluation of immune thrombocytopenic purpura (ITP)?

What does a finding of splenomegaly indicate in the evaluation of immune thrombocytopenic purpura (ITP)?

Which nervous system findings are characteristic of immune thrombocytopenic purpura (ITP)?

DDX

What are the differential diagnoses for Immune Thrombocytopenic Purpura (ITP)?

Workup

What is the initial lab test performed in the evaluation of immune thrombocytopenic purpura (ITP)?

What is the role of peripheral blood smear in the diagnosis of immune thrombocytopenic purpura (ITP)?

What is the significance of clumps of platelets on peripheral blood smear in the evaluation of immune thrombocytopenic purpura (ITP)?

When is HIV testing indicated in the evaluation of immune thrombocytopenic purpura (ITP)?

What medical history suggests immune thrombocytopenic purpura (ITP) in women?

What is the role of measles-mumps-rubella (MMR) immunization in children with suspected immune thrombocytopenic purpura (ITP)?

What is the role of platelet antigen assays in the evaluation of immune thrombocytopenic purpura (ITP)?

What is the role of Helicobacter (H) pylori infection testing in the evaluation of immune thrombocytopenic purpura (ITP)?

What is the risk of undiagnosed HIV infection in patients with immune thrombocytopenic purpura (ITP)?

What is the role of imaging studies in the diagnosis of immune thrombocytopenic purpura (ITP)?

What are the histologic findings characteristic of immune thrombocytopenic purpura (ITP)?

Which bone marrow biopsy results are characteristic of immune thrombocytopenic purpura (ITP)?

What should be included in the evaluation of the spleen in patients with immune thrombocytopenic purpura (ITP)?

What is the role of bone marrow aspiration and biopsy in the diagnosis of immune thrombocytopenic purpura (ITP)?

When is bone marrow exam indicated in adults with suspected immune thrombocytopenic purpura (ITP)?

What are the ASH guidelines for bone marrow exam in the evaluation of immune thrombocytopenic purpura (ITP)?

When is bone marrow exam indicated in children with suspected immune thrombocytopenic purpura (ITP)?

Treatment

What is the goal of medical care for immune thrombocytopenic purpura (ITP)?

What is the role of corticosteroids in the treatment of immune thrombocytopenic purpura (ITP)?

Which diagnostic procedures should be considered to confirm the diagnosis of immune thrombocytopenic purpura (ITP)?

What is the role of IV immunoglobulin (IVIG) in the treatment of immune thrombocytopenic purpura (ITP)?

What is the role of IV Rho immunoglobulin (RhIG) in the treatment of immune thrombocytopenic purpura (ITP)?

How is immune thrombocytopenic purpura (ITP) managed in children?

What are the ASH treatment guidelines for immune thrombocytopenic purpura (ITP) in pediatric patients?

What are the risks of IV Rho immunoglobulin (RhIG) in the treatment of immune thrombocytopenic purpura (ITP) in children?

What are the benefits of IV Rho immunoglobulin (RhIG) in the treatment of immune thrombocytopenic purpura (ITP) in children?

Which medications are used to treat immune thrombocytopenic purpura (ITP) in adults?

How are bleeding risk factors managed in the treatment of immune thrombocytopenic purpura (ITP) in adults?

How is immune thrombocytopenic purpura (ITP) managed during pregnancy?

Which medications are contraindicated in the treatment of immune thrombocytopenic purpura (ITP) during pregnancy?

Which medications with uncertain efficacy have been used to treat immune thrombocytopenic purpura (ITP)?

What is the role of romiplostin in the treatment of chronic immune thrombocytopenic purpura (ITP)?

What is the role of eltrombopag in the treatment of immune thrombocytopenic purpura (ITP)?

What is the role of avatrombopag in the treatment of immune thrombocytopenic purpura (ITP)?

When is splenectomy indicated in the treatment of immune thrombocytopenic purpura (ITP)?

What are the risks of splenectomy in immune thrombocytopenic purpura (ITP)?

What are possible complications of splenectomy in the treatment of immune thrombocytopenic purpura (ITP)?

What is the role of immunization in the treatment of immune thrombocytopenic purpura (ITP)?

What are signs of an accessory spleen following splenectomy for immune thrombocytopenic purpura (ITP)?

Which specialist consultations are needed for the management of immune thrombocytopenic purpura (ITP)?

Guidelines

What are the ASH treatment guidelines for immune thrombocytopenic purpura (ITP)?

What are the ASH recommendations for diagnosis of pediatric immune thrombocytopenic purpura (ITP)?

What are the ASH recommendations for the basis of treatment for immune thrombocytopenic purpura (ITP) in children?

What are the ASH recommendations for the initial treatment of immune thrombocytopenic purpura (ITP) in children?

What are the ASH recommendations for treatment of resistant immune thrombocytopenic purpura (ITP) in children?

What are the ASH recommendations for splenectomy to treat immune thrombocytopenic purpura (ITP) in children?

What are the ASH recommendations for H pylori testing in children with immune thrombocytopenic purpura (ITP)?

What are the ASH recommendations for the workup of immune thrombocytopenic purpura (ITP) in adults?

What are the ASH recommendations for first-line treatment of immune thrombocytopenic purpura (ITP) in adults?

What are the ASH recommendation for second-line therapies for immune thrombocytopenic purpura (ITP) in adults?

What are the ASH recommendations for treatment of immune thrombocytopenic purpura (ITP) in patients at risk of bleeding?

What are the ASH recommendations for splenectomy to treat immune thrombocytopenic purpura (ITP) in adults?

What are the ASH recommendations for diagnosis of thrombocytopenia during pregnancy?

Which tests may be clinically indicated for the diagnosis of thrombocytopenia during pregnancy?

Which studies are not recommended by ASH for the diagnosis of thrombocytopenia during pregnancy?

What are the ASH recommendation for treatment of immune thrombocytopenic purpura (ITP) during pregnancy?

What are the expected responses to first-line therapy for immune thrombocytopenic purpura (ITP) during pregnancy?

What are the ASH recommendations for second and third-line therapy for immune thrombocytopenic purpura (ITP) during pregnancy?

Which drugs are contraindicated in the treatment of immune thrombocytopenic purpura (ITP) during pregnancy?

What are the ASH recommendations for the treatment of immune thrombocytopenic purpura (ITP) during delivery?

Medications

What is required for the treatment of acute immune thrombocytopenic purpura (ITP)?

What is the initial treatment of immune thrombocytopenic purpura (ITP)?

What is the second-line treatment for immune thrombocytopenic purpura (ITP)?

What is the third-line treatment for immune thrombocytopenic purpura (ITP)?

What are the treatment options for chronic immune thrombocytopenic purpura (ITP)?

What are the risks of treating chronic, refractory immune thrombocytopenic purpura (ITP)?

How are thrombopoietin mimetics used in the treatment of immune thrombocytopenic purpura (ITP)?

Which medications in the drug class Corticosteroids are used in the treatment of Immune Thrombocytopenic Purpura (ITP)?

Which medications in the drug class Blood Products are used in the treatment of Immune Thrombocytopenic Purpura (ITP)?

Which medications in the drug class Immunosuppressive Antimetabolites are used in the treatment of Immune Thrombocytopenic Purpura (ITP)?

Which medications in the drug class Synthetic Antineoplastic Drugs are used in the treatment of Immune Thrombocytopenic Purpura (ITP)?

Which medications in the drug class Androgens are used in the treatment of Immune Thrombocytopenic Purpura (ITP)?

Which medications in the drug class Monoclonal Antibodies are used in the treatment of Immune Thrombocytopenic Purpura (ITP)?

Which medications in the drug class Thrombopoietic Agents are used in the treatment of Immune Thrombocytopenic Purpura (ITP)?

Which medications in the drug class SYK Inhibitors are used in the treatment of Immune Thrombocytopenic Purpura (ITP)?

Follow-up

What are the complications of splenectomy for the treatment of immune thrombocytopenic purpura (ITP)?