Idiopathic thrombocytopenic purpura overview: Difference between revisions
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The cause of ITP is thought to be related to chronic infections such as [[HIV]], [[hepatitis C]] and [[H. Pylori]]. | The cause of ITP is thought to be related to chronic infections such as [[HIV]], [[hepatitis C]] and [[H. Pylori]]. | ||
==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
The incidence of ITP is | The incidence of ITP is 5-10 new cases per 100,000 per year, with children accounting for half of that amount. The male:female ratio in the adult group is 1:1.2–1.7 (for children it is 1:1) and the median age of adults at the diagnosis is 56–60.<ref name="pmid15941913">{{cite journal |author=Cines DB, Bussel JB |title=How I treat idiopathic thrombocytopenic purpura (ITP) |journal=Blood |volume=106 |issue=7 |pages=2244-51 |year=2005 |pmid=15941913 |doi=10.1182/blood-2004-12-4598}}</ref> | ||
==Diagnosis== | ==Diagnosis== | ||
===Other Diagnostic Studies=== | ===Other Diagnostic Studies=== | ||
Revision as of 15:26, 13 March 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Idiopathic thrombocytopenic purpura (ITP) is the condition of having a low platelet count (thrombocytopenia) of no known cause (idiopathic). As most causes appear to be related to antibodies against platelets, it is also known as immune thrombocytopenic purpura. Although most cases are asymptomatic, very low platelet counts can lead to a bleeding diathesis and purpura.
Causes
The cause of ITP is thought to be related to chronic infections such as HIV, hepatitis C and H. Pylori.
Epidemiology and Demographics
The incidence of ITP is 5-10 new cases per 100,000 per year, with children accounting for half of that amount. The male:female ratio in the adult group is 1:1.2–1.7 (for children it is 1:1) and the median age of adults at the diagnosis is 56–60.[1]
Diagnosis
Other Diagnostic Studies
A bone marrow examination may be performed on patients over the age of 60 and people who do not respond to treatment, or when the diagnosis is in doubt. The bone marrow biopsy in ITP can show increased (thought not always) megakaryocytes, bizarre giant platelets and platelet fragments. (Large platelets are often seen in the peripheral blood smear though this can be seen in other diseases.) When the spleen is removed it may show increased lymphatic nodularity.
Treatment
Radiation
Splenic radiation (RT) is usually given for steroid-resistant ITP. One to six weeks of 75-1370 cGy with or without concomittant post-RT steroids. Patients can respond for >1 year. It is a safe alternative for patients too old for splenectomy.
Primary Prevention
The causes and risk factors are unknown, except in children when it may be related to a viral infection. Prevention methods are unknown.
References
- ↑ Cines DB, Bussel JB (2005). "How I treat idiopathic thrombocytopenic purpura (ITP)". Blood. 106 (7): 2244–51. doi:10.1182/blood-2004-12-4598. PMID 15941913.