Management of adult idiopathic thrombocytopenic purpura.
Idiopathic thrombocytopenic purpura (ITP) is a common hematologic disorder manifested by immune-mediated thrombocytopenia. The diagnosis remains one of exclusion, after other thrombocytopenic disorders are ruled out based on history, physical examination, and laboratory evaluation. The goal of treatment is to raise the platelet count into a hemostatically safe range. The disorder is usually chronic, although there is considerable variation in the clinical course and most patients eventually attain safe platelet counts off treatment. However, a subset of patients has severe disease refractory to all treatment modalities, which is associated with considerable morbidity and mortality. This article focuses on the management of primary ITP in adults. We discuss criteria for treatment, the roles of splenectomy and other treatment options along with their side effects, and the management of ITP during pregnancy.
Cines
Douglas B
DB
Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA. dcines@mail.med.upenn.edu
McMillan
Robert
R
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D018951:Antigens, CD20 / Q000276:immunology; D001323:Autoantibodies / Q000097:blood; D001792:Blood Platelets / Q000276:immunology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011247:Pregnancy; D011296:Prenatal Diagnosis; D011379:Prognosis; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000175:diagnosis / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D013156:Splenectomy; D015996:Survival Rate; D017211:Treatment Failure
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D018951:Antigens, CD20; D001323:Autoantibodies; D007166:Immunosuppressive Agents