Idiopathic thrombocytopenic purpura (ITP), also referred toas primary immune thrombocytopenic purpura, is defined by alow platelet count, normal bone marrow, and the absence of othercauses of thrombocytopenia. This review focuses on ITP and itsmanagement in adults. Typically, adult ITP is a chronic disease.
Clinical Features
Presentation
Among adults, ITP is most common in young women: 72 percentof patients over 10 years old are women, and 70 percent of thesewomen are less than 40 years old1. The onset is often insidious.History and physical examination are normal except for symptomsand signs of the type of bleeding . . . [Full Text of this Article]
Laboratory Evaluation
Differential Diagnosis
Course and Prognosis
Pathophysiology
Management
Initial Management
Management of Severe Bleeding
Management of ITP in Pregnancy
Splenectomy
Management of Persistent Thrombocytopenia
Source Information
From the Hematology-Oncology Section, Department of Medicine (J.N.G., M.A.E.-H., G.E.R.), and the Department of Biostatistics and Epidemiology (G.E.R.), University of Oklahoma Health Sciences Center, Oklahoma City.
Address reprint requests to Dr. George at the Hematology-Oncology Section, Department of Medicine, University of Oklahoma Health Sciences Center, P.O. Box 26901, Oklahoma City, OK 73190.
Ruggeri, M., Fortuna, S., Rodeghiero, F.
(2008). Heterogeneity of terminology and clinical definitions in adult idiopathic thrombocytopenic purpura: a critical appraisal from a systematic review of the literature. haematol
93: 98-103
[Abstract][Full Text]
Mazzucconi, M. G., Fazi, P., Bernasconi, S., De Rossi, G., Leone, G., Gugliotta, L., Vianelli, N., Avvisati, G., Rodeghiero, F., Amendola, A., Baronci, C., Carbone, C., Quattrin, S., Fioritoni, G., D'Alfonso, G., Mandelli, F., for the Gruppo Italiano Malattie EMatologiche dell,
(2007). Therapy with high-dose dexamethasone (HD-DXM) in previously untreated patients affected by idiopathic thrombocytopenic purpura: a GIMEMA experience. Blood
109: 1401-1407
[Abstract][Full Text]
Kim, M. W., Choi, H. M.
(2006). Fetal Hydrocephalus in a Pregnancy Complicated by Idiopathic Thrombocytopenic Purpura. J Ultrasound Med
25: 777-780
[Full Text]
Sakakura, M., Wada, H., Abe, Y., Nishioka, J., Tomatsu, H., Hamaguchi, Y., Oguni, S., Shiku, H., Nobori, T.
(2005). Usefulness of Measurement of Reticulated Platelets for Diagnosis of Idiopathic Thrombocytopenic Purpura. CLIN APPL THROMB HEMOST
11: 253-261
[Abstract]
Abe, Y., Wada, H., Sakakura, M., Nishioka, J., Tomatsu, H., Hamaguchi, Y., Oguni, S., Shiku, H., Nobori, T.
(2005). Usefulness of Fully Automated Measurement of Reticulated Platelets Using Whole Blood. CLIN APPL THROMB HEMOST
11: 263-270
[Abstract]
Cheng, Y., Wong, R. S.M., Soo, Y. O.Y., Chui, C. H., Lau, F. Y., Chan, N. P.H., Wong, W. S., Cheng, G.
(2003). Initial Treatment of Immune Thrombocytopenic Purpura with High-Dose Dexamethasone. NEJM
349: 831-836
[Abstract][Full Text]
Huhn, R. D., Fogarty, P. F., Nakamura, R., Read, E. J., Leitman, S. F., Rick, M. E., Kimball, J., Greene, A., Hansmann, K., Gratwohl, A., Young, N., Barrett, A. J., Dunbar, C. E.
(2003). High-dose cyclophosphamide with autologous lymphocyte-depleted peripheral blood stem cell (PBSC) support for treatment of refractory chronic autoimmune thrombocytopenia. Blood
101: 71-77
[Abstract][Full Text]
Michel, M., Khellaf, M., Desforges, L., Lee, K., Schaeffer, A., Godeau, B., Bierling, P.
(2002). Autoimmune Thrombocytopenic Purpura and Helicobacter pylori Infection. Arch Intern Med
162: 1033-1036
[Abstract][Full Text]
Gomez, F., Ruiz, P., Lopez, R., Rivera, C.
(2002). Treatment with Megestrol Acetate Improves Human Immunodeficiency Virus-Associated Immune Thrombocytopenia. CVI
9: 583-587
[Abstract][Full Text]
Cines, D. B., Blanchette, V. S.
(2002). Immune Thrombocytopenic Purpura. NEJM
346: 995-1008
[Full Text]
Emilia, G., Morselli, M., Luppi, M., Longo, G., Marasca, R., Gandini, G., Ferrara, L., D'Apollo, N., Potenza, L., Bertesi, M., Torelli, G.
(2002). Long-term salvage therapy with cyclosporin A in refractory idiopathic thrombocytopenic purpura. Blood
99: 1482-1485
[Abstract][Full Text]
Kosugi, S., Tomiyama, Y., Honda, S., Kato, H., Kiyoi, T., Kashiwagi, H., Kurata, Y., Matsuzawa, Y.
(2001). Platelet-associated anti-GPIIb-IIIa autoantibodies in chronic immune thrombocytopenic purpura recognizing epitopes close to the ligand-binding site of glycoprotein (GP) IIb. Blood
98: 1819-1827
[Abstract][Full Text]
Portielje, J. E. A., Westendorp, R. G. J., Kluin-Nelemans, H. C., Brand, A.
(2001). Morbidity and mortality in adults with idiopathic thrombocytopenic purpura. Blood
97: 2549-2554
[Abstract][Full Text]
Alves-Rosa, F., Stanganelli, C., Cabrera, J., van Rooijen, N., Palermo, M. S., Isturiz, M. A.
(2000). Treatment with liposome-encapsulated clodronate as a new strategic approach in the management of immune thrombocytopenic purpura in a mouse model. Blood
96: 2834-2840
[Abstract][Full Text]
Martlew, V. J.
(2000). Peri-operative management of patients with coagulation disorders. Br J Anaesth
85: 446-455
[Abstract][Full Text]
Gomez, F., Ruiz, P., Lopez, R., Rivera, C., Romero, S., Bernal, J. A.
(2000). Effects of Androgen Treatment on Expression of Macrophage Fcgamma Receptors. CVI
7: 682-686
[Abstract][Full Text]
BOEHLEN, F., HOHLFELD, P., EXTERMANN, P., DE MOERLOOSE, P.
(1999). Maternal Antiplatelet Antibodies in Predicting Risk of Neonatal Thrombocytopenia. Obstet Gynecol
93: 169-173
[Abstract][Full Text]
Law, C., Marcaccio, M., Tam, P., Heddle, N., Kelton, J. G.
(1997). High-Dose Intravenous Immune Globulin and the Response to Splenectomy in Patients with Idiopathic Thrombocytopenic Purpura. NEJM
336: 1494-1498
[Abstract][Full Text]
Bibas, M., Garrido, J. A., George, J. N., El-Harake, M., Raskob, G. E.
(1995). Chronic Idiopathic Thrombocytopenic Purpura. NEJM
332: 685-686
[Full Text]