Immune Thrombocytopenia

Immune thrombocytopenia (ITP) is an acquired thrombocytopenia, defined as a platelet count <100,000/μL, caused by immune destruction of platelets. The reduced peripheral blood platelet count results from premature destruction and a relative inadequacy of platelet production. ITP occurs in people of all ages, with around 40% of cases affecting children under ten. Approximately 80% of children with ITP present with an acute, self-limiting form of the condition. Adults more commonly develop the chronic form of ITP, resulting in a higher prevalence among those over 60 years of age. An estimated 50% to 70% of adults with ITP have the chronic form. The diagnosis of ITP is based principally on excluding other causes of isolated thrombocytopenia using patient history, physical examination, blood count, and evaluation of the peripheral blood smear. No “gold standard” test exists to establish the diagnosis reliably. The first line of treatment includes corticosteroids such as dexamethasone. Second-line medical therapies include thrombopoietin receptor agonists (TPO-RAs), rituximab, fostamatinib, and other immunosuppressive drugs.