ITP-Immune Thrombocytopenic Purpura
Angel A. Justiz Vaillant, Nagendra Gupta
Abstract
Immune thrombocytopenic purpura (ITP) is an autoimmune pathology characterized by a low platelet count, purpura, and hemorrhagic episodes caused by antiplatelet autoantibodies. The diagnosis is typically made by the exclusion of the known causes of thrombocytopenia. IgG autoantibodies sensitize the circulating platelets. It leads to accelerated removal of these cells by antigen-presenting cells (macrophages) of the spleen, and sometimes the liver or other components of the monocyte-macrophage system. Bone marrow compensates the platelet destruction by increasing platelet production. ITP most often occurs in healthy children and young adults within a few weeks following a viral infection. ITP is usually manageable with immunosuppressive therapy. An identical form of autoimmune thrombocytopenia can also be associated with chronic lymphocytic leukemia, lymphomas, SLE, infectious mononucleosis, and other bacterial and viral infections. Certain drugs can also cause immune thrombocytopenia indistinguishable from ITP. Most children have spontaneous remission within a few weeks or months, and splenectomy is rarely needed. However, young adults rarely have spontaneous remissions necessitating splenectomy within the first few months after diagnosis.