Immune Thrombocytopenia (ITP)

Haematology

Isolated thrombocytopenia from antiplatelet autoantibodies with no other cause identified.

Investigations

  • FBC with blood film (exclude clumping, blasts, schistocytes)
  • HIV, hepatitis C, H. pylori testing
  • Immunoglobulins and ANA
  • Bone marrow only if atypical features

Management

  • Observe if platelets >30 ×10⁹/L and no bleeding
  • Prednisolone 1 mg/kg or dexamethasone 40 mg × 4 days
  • IVIG 1 g/kg if urgent rise required
  • Second line: TPO receptor agonists, rituximab, splenectomy

Clinical pearls

  • Platelet transfusion is ineffective except in life-threatening bleeding
  • Avoid NSAIDs and antiplatelets

Related in WardRound

Educational — verify locally.

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