Management of Immune Thrombocytopenic Purpura in Adults

Stasi, Roberto; Provan, Drew
April 2004
Mayo Clinic Proceedings;Apr2004, Vol. 79 Issue 4, p504
Academic Journal
Primary immune thrombocytopenic purpura (ITP), also referred to as idiopathic thrombocytopenic purpura, is an organ-specific autoimmune disorder in which antibodycoated or immune complex-coated platelets are destroyed prematurely by the reticuloendothelial system, resulting in peripheral blood thrombocytopenia. The disease is heterogeneous with regard to its severity and clinical course and is unpredictable in its response to therapy. Although the basic underlying pathophysiology of ITP has been known for more than 50 years, current treatment guidelines are based on expert opinion rather than on evidence because of a lack of high-quality clinical trials and research. The only patients for whom treatment is clearly required are those with severe bleeding and/or extremely low platelet counts (<10 × 109/L). Treatment of patients with ITP refractory to corticosteroids and splenectomy requires careful evaluation of disease severity, patient characteristics related to risk of bleeding, and adverse effects associated with treatment. Clinical trials with numerous new agents are under way, which we hope will add more effective and targeted strategies to our therapeutic armamentarium. We describe a logical and structured approach to the clinical management of ITP in adults, based on a literature review and our personal experience.


Related Articles

  • Chronic immune thrombocytopenic purpura-who needs medication? Bolton-Maggs, Paula H. B.; Kok, Victoria S. L. // Annals of Hematology;Jul2010, Vol. 89, p61 

    Chronic ITP (immune thrombocytopenic purpura; now defined as duration of more than 12 months) is not always associated with significant bleeding problems so that most children and adults can be managed expectantly with no medication unless surgery, accidents or other pathology mandate it. A...

  • Evaluation of 143 Cases of Immune Thrombocytopenic Purpura With Regards to Clinical Course and Response to Treatment. Albayrak, Murat; Balcik, Ozlem Sahin; Zeynep Aki, Sahika; Gokmen, Ayla; Ceran, Funda; Yokus, Osman; Dagdas, Simten; Ayli, Meltem; Ozet, Gulsum // Eurasian Journal of Medicine;Dec2010, Vol. 42 Issue 3, p120 

    Objective: Immune thrombocytopenic purpura (ITP) is also known as idiopathic thrombocytopenic purpura. Increased platelet destruction and insufficient platelet production are both responsible for its etiopathogenesis. ITP can be diagnosed after excluding other possible causes of...

  • Treatment options for chronic immune thrombocytopenic purpura. Pruemer, Jane // American Journal of Health-System Pharmacy;1/16/2009, Vol. 66 Issue S2, pS3 

    The article offers information on treatment options for chronic immune thrombocytopenic purpura (ITP). It states that ITP is an autoimmune disorder characterized by thrombocytopenia due to increased platelet destruction and decreased platelet production. It also mentions that severe...

  • Thrombocytopenic Purpura. Vohr, Hans-Werner // Encyclopedic Reference of Immunotoxicology;2005, p638 

    An encyclopedia entry for thrombocytopenic purpura is presented. It is a rare autoimmune disorder characterized by a shortage of platelets. This leads to bruising and spontaneous bleeding. Most of the cases are idiopathic while others are caused by drugs, infections or autoimmune disorders such...

  • Diagnosis and management of chronic ITP: comments from an ICIS expert group. Grainger, John David; Bolton-Maggs, Paula H. B.; Godeau, Bertrand; Bussel, Jim; Donato, Hugo; Elalfy, Mohsen; Hainmann, Ina; Matzdorff, Axel; Müller-Beissenhirtz, Hannes; Rovó, Alicia; Tichelli, Andre; Müller-Beissenhirtz, Hannes; Rovó, Alicia // Annals of Hematology;Jul2010, Vol. 89, p11 

    Immune thrombocytopenia (ITP) is a common disorder in children and adults. In a patient with newly diagnosed ITP, the treatment strategy is relatively well defined. Second-line treatments are more controversial, and the management of chronic ITP is even more so. During the 3rd ICIS Expert...

  • Laparoscopic splenectomy for idiopathic thrombocytopenic purpura (ITP). Pace, D.E.; Chiasson, P.M.; Schlachta, C.M.; Mamazza, J.; Poulin, E.C. // Surgical Endoscopy;Jan2003, Vol. 17 Issue 1, p95 

    Background: Although the short-term benefits of laparoscopic splenectomy (LS) have been well documented, long-term follow-up data of patients who have undergone LS for ITP are scarce. We report our long-term follow-up data in patients who underwent LS for idiopathic thrombocytopenic purpura...

  • Diagnosis and Treatment of Idiopathic Thrombocytopenic Purpura. Kahanov, Leamor; Eberman, Lindsey E.; Grammer, Shaun // International Journal of Athletic Therapy & Training;Mar2012, Vol. 17 Issue 2, p25 

    The article discusses the condition of idiopathic thrombocytopenic purpura (ITP), its diagnosis and treatment in young adults. It refers to ITP as an antibody response to proteins on platelets that lead to their destruction and diminished platelet production and its symptoms may include...

  • Epidemiology, pathophysiology, and initial management of chronic immune thrombocytopenic purpura. Pruemer, Jane // American Journal of Health-System Pharmacy;1/16/2009, Vol. 66 Issue S2, pS4 

    Purpose. The incidence and epidemiology, the pathogenesis, the clinical symptoms and diagnosis and the first-line therapies for the management of chronic immune thrombocytopenic purpura (ITP) are discussed. In addition, the recommendations of two expert panels for the management of ITP are...

  • Accessory Splenectomy in the Management of Recurrent Immune Thrombocytopenic Purpura. Walters, David N.; Roberts, Jerry L.; Votaw, May // American Surgeon;Nov1998, Vol. 64 Issue 11, p1077 

    Describes a case of recurrent thrombocytopenia associated with an accessory spleen occurring 5 years after splenectomy in a young woman with chronic immune thrombocytopenic purpura (ITP). Causes of failures of splenectomy; Success of accessory splenectomy in producing a sustained remission;...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics