Chronic Idiopathic Thrombocytopenic Purpura (ITP) better called Immune Thrombocytopenic Purpura is an indolent disorder in which the cause of thrombocytopenia is not known and it may persist for years, even for life. Women aged 20- 40 are commonly affected, with a male female ratio of 1: 3. Recent studies indicate that ITP may more common in older individuals of both male and female. They may present with an abrupt fall in platelet count and bleeding which can be mild and insignificant to life threatening massive bleed, especially intracranial.
It is an autoimmune disorder of unknown etiology where platelet membrane protein associated IgG can be seen in the serum but specificity is questionable. Bone marrow examination is essentially normal with an increase in the megakariocytes. Before diagnosis of Chronic ITP is made, one has to exclude thrombocytopenia due to Drugs/ Chemicals/ SLE/ HIV/ Liver diseases and inherited disorders. Usual treatment is with Prednisolone 1 mg/ kg (60 mg/ day) for 4- 6 weeks. About 50% normalise their platelet count. Some may require low doses of steroid to keep the count sufficient to prevent any bleeding episodes. Rarely patients can remain asymptomatic for years even with platelet count as low as 2000. In general they are asymptomatic and needs no treatment except careful follow up when the platelet counts are above 20000.
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