Find a doctor 
Contact us 
Immune thrombocytopenia (ITP) is a disorder in which the immune system mistakenly produces antibodies against the body’s own platelets. As a result, platelets are destroyed primarily in the spleen and liver, leading to a decreased platelet count in the blood. This reduction increases the risk of bleeding.
Statistics:
In children, ITP often develops following an infection, has an acute course, and usually resolves spontaneously within 6 months. The annual incidence is approximately 2–6 cases per 100,000 children. In adults, the disease more often takes a chronic course, typically presenting between the ages of 30 and 60, and occurs more frequently in women than in men.
Clinical manifestations:
Patients may develop small reddish skin spots (petechiae), bruises, and mucosal bleeding, such as epistaxis and gingival bleeding. Women may experience heavy menstrual bleeding. In severe cases, gastrointestinal or intracranial hemorrhage may occur, which can be life-threatening.
Diagnosis:
A complete blood count usually reveals isolated thrombocytopenia as the main abnormality. Peripheral blood smear helps assess platelet morphology. In older patients or when the diagnosis is uncertain, bone marrow aspiration may be performed. ITP is a diagnosis of exclusion; therefore, additional tests may be required to rule out other conditions, including biochemical blood tests, screening for viral infections (e.g., HIV, hepatitis C), and autoimmune markers when clinically indicated.
Treatment
First-line therapy: Corticosteroids (e.g., Prednisolone, Dexamethasone). In emergencies, intravenous immunoglobulin (IVIG) or, in some cases, anti-D immunoglobulin may be administered.
Second-line therapy: For patients who are unresponsive to first-line treatment, options include rituximab (a monoclonal antibody) and thrombopoietin receptor agonists (e.g., Eltrombopag, Romiplostim), which stimulate platelet production. Splenectomy may be considered in selected cases with inadequate treatment response.
Third-line therapy: In refractory cases, immunosuppressive agents (e.g., Azathioprine, Mycophenolate, Cyclophosphamide) or novel targeted therapies under investigation may be used.
