Introducing
Your new presentation assistant.
Refine, enhance, and tailor your content, source relevant images, and edit visuals quicker than ever before.
Trending searches
*In adults, therapy may be required for patients with platelet counts lower than 30,000 to 40,000/µL (30-40 × 109/L) or with bleeding. Initial therapy consists of prednisone or methylprednisolone (1-2 mg/kg/d)
*Some health care providers advocate initial therapy with dexamethasone (40 mg/d for 4 days) owing to a higher response and lower relapse rate. Initial responses to corticosteroid therapy, without relapse, occur in 25% of patients, but treatment failures occur in 75%.
* Patients who do not respond to corticosteroid therapy and who continue to bleed should be treated with an additional agent such as intravenous immune globulin or anti-D immune globulin or with newer options, such as rituximab or mycophenolate mofetil.
*Splenectomy can also be considered, but awareness of postsplenectomy complications and the availability of more immunosuppressant options have decreased its use. Splenectomy leads to a sustained remission in 75% of patients
*Adjunctive therapy, including intravenous immune globulin or anti-D immune globulin, with corticosteroids is appropriate for the initial therapy of patients in whom a rapid rise in platelets is desirable because of bleeding or a platelet count lower than 10,000/µL (10 × 10/L).
* Two new agents that stimulate the thrombopoietin receptor and induce platelet production, romiplostim and eltrombopag, have been approved for use in refractory ITP.
*The risk of bleeding from continued thrombocytopenia must be weighed against the toxicity of additional treatment when the need for alternative immunosuppressive therapy is considered in patients who are refractory to initial corticosteroid therapy.
* Some patients with chronic ITP can tolerate thrombocytopenia for long periods without symptomatic bleeding.β-Lactam antibiotics, cephalosporins, sulfa-containing drugs, vancomycin, quinine and its derivatives, and glycoprotein IIb/IIIa inhibitors can cause ITP. Discontinuation of the offending drug should result in platelet recovery
The secondary causes of ITP include antiphospholipid syndrome, drug side effects, infections (CMV, H. pylori, HCV, HIV, varicella zoster), lymphoproliferative disorders, bone marrow transplant, vaccination side effect, and systemic lupus erythematosus.
Definition:
*Not all patients with ITP require therapy, and monitoring for signs of bleeding or further declines in platelet counts may be appropriate.
*Asymptomatic patients without evidence of bleeding and platelet counts above 30,000 to 40,000/µL (30-40 × 109/L) have less than a 15% chance of developing more severe thrombocytopenia requiring treatment.
*In such patients, the most appropriate course of action is to provide counseling on potential bleeding symptoms and repeat the complete blood count at a designated interval, generally 1 to 2 weeks.
THANK YOU!
*Immune (also termed “idiopathic”) thrombocytopenic purpura (ITP) is an acquired autoimmune condition in which autoantibodies are directed against platelet surface proteins, leading to platelet destruction that may be only partially counteracted by increased bone marrow platelet production.
*ITP is a common disorder, occurring more often in children than adults, but the course is frequently self-limited in children and not in adults
Clinical findings may include signs or symptoms of mild to severe bleeding or hemorrhage.
Although ITP is a diagnosis of exclusion, supportive clinical findings include an otherwise normal blood count or concomitant anemia from bleeding and the absence of additional organ dysfunction
Platelets, when present, may be large because typically, they would have been recently released from the marrow, and the enhanced hemostatic function of these young platelets may account for less severe bleeding symptoms than those associated with other diseases with a similar platelet count.