Immune Thrombocytopenia (ITP) Questions & Answers

Updated: Jan 11, 2020
  • Author: Craig M Kessler, MD, MACP; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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Questions & Answers

Overview

What is immune thrombocytopenia (ITP)?

What are the signs and symptoms of immune thrombocytopenia (ITP)?

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

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

Which findings suggest intracranial hemorrhage in immune thrombocytopenia (ITP)?

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

How is immune thrombocytopenia (ITP) diagnosed?

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

How is immune thrombocytopenia (ITP) treated?

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

Why was the term "immune thrombocytopenic purpura" abandoned?

What is the pathophysiology of immune thrombocytopenia (ITP)?

What causes immune thrombocytopenia (ITP)?

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

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

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

How are platelets destroyed in thrombocytopenia (ITP)?

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

What is the global prevalence of immune thrombocytopenia (ITP)?

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

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

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

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

How does the prognosis of immune thrombocytopenia (ITP) vary?

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

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

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

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

Presentation

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

Which systemic illnesses may manifest as immune thrombocytopenia (ITP)?

Which clinical history findings are characteristic of immune thrombocytopenia (ITP) in children?

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

Which medications may cause immune thrombocytopenia (ITP)?

How is drug-induced thrombocytopenia diagnosed?

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

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

Which antiplatelet drugs may cause immune thrombocytopenia (ITP)?

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

Which hepatic history findings are characteristic of immune thrombocytopenia (ITP)?

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

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

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

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

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

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

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

DDX

Which conditions are included in the differential diagnosis of immune thrombocytopenia (ITP)?

What are the differential diagnoses for Immune Thrombocytopenia (ITP)?

Workup

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

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

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

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

What medical history suggests immune thrombocytopenia (ITP) in women?

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

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

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

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

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

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

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

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

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

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

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

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

Treatment

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

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

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

What are the second-line treatment options for immune thrombocytopenia (ITP)?

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

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

How is immune thrombocytopenia (ITP) managed in children?

How is immune thrombocytopenia (ITP) treated in adults?

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

What is the role of fostamatinib in the treatment of immune thrombocytopenia (ITP) in adults?

How is immune thrombocytopenia (ITP) managed during pregnancy?

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

What is the role of thrombopoietin receptor agonists in the treatment of immune thrombocytopenia (ITP)?

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

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

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

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

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

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

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

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

Guidelines

What guidelines are available for immune thrombocytopenia (ITP)?

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

What are the ASH recommendations for the treatment of immune thrombocytopenia (ITP) in children?

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

What are the ASH recommendations for treatment of immune thrombocytopenia (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 thrombocytopenia (ITP) during pregnancy?

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

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

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

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

What are the International Consensus Report recommendations for the diagnosis of immune thrombocytopenia (ITP) during pregnancy?

What are the International Consensus Report recommendations for obstetric analgesia and anesthesia in women with immune thrombocytopenia (ITP)?

What are the International Consensus Report recommendations for the treatment of immune thrombocytopenia (ITP) during delivery?

What are the International Consensus Report recommendations for treatment of neonates born to women with immune thrombocytopenia (ITP)?

What are the International Consensus Report recommendations for the workup of immune thrombocytopenia in children?

What are the International Consensus Report guidelines for grading bleeding in children with immune thrombocytopenia (ITP)?

What are the International Consensus Report recommendations for watch-and -wait in children with immune thrombocytopenia (ITP)?

According to the International Consensus Report guidelines, when is treatment indicated in children with immune thrombocytopenia (ITP)?

What are the International Consensus Report recommendations for initial treatment of children with immune thrombocytopenia (ITP)?

What are the International Consensus Report recommendations for emergency treatment of children with immune thrombocytopenia (ITP)?

What are the International Consensus Report recommendations for treatment of children with chronic immune thrombocytopenia (ITP)?

What are the International Consensus Report recommendations for splenectomy to treat children with immune thrombocytopenia (ITP)?

What are the International Consensus Report recommendations for quality of life assessment in children with immune thrombocytopenia (ITP)?

What are the International Consensus Report recommendations for physical activity and sports participation in children with immune thrombocytopenia (ITP)?

What are the International Consensus Report recommendations for the treatment of immune thrombocytopenia (ITP) during pregnancy?

What are the International Consensus Report recommendations for the workup of immune thrombocytopenia (IPT) in adults?

Which tests are not recommended by the International Consensus Report for the diagnosis of Immune Thrombocytopenia (IPT) in adults?

What are the International Consensus Report recommendations for the initial treatment of immune thrombocytopenia (ITP) in adults?

What are the International Consensus Report guidelines for ongoing treatment of immune thrombocytopenia (IPT)?

What are the International Consensus Report recommendations for treatment of life threatening bleeding in adults with immune thrombocytopenia (ITP)?

What are the International Consensus Report recommendations for the surgical treatment of immune thrombocytopenia (ITP)?

What are the International Consensus Report guidelines for the treatment of immune thrombocytopenia (ITP) after multiple treatment failures?

What are the International Consensus Report recommendations for the assessment of quality of life outcomes in adults with immune thrombocytopenia (ITP)?

What are the International Consensus Report recommendations for participation in high-risk activities for adults with immune thrombocytopenia (ITP)?

Medications

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

What is the initial treatment of acute immune thrombocytopenia (ITP) in children?

What is the second-line treatment for acute immune thrombocytopenia (ITP) in children?

What is the third-line treatment for acute immune thrombocytopenia (ITP) in children?

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

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

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

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

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

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

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

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

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

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