Idiopathic Thrombocytopenic Purpura (ITP): The Daily PANCE Blueprint
Which of the following is the definitive treatment of immune thrombocytopenic purpura?
A. Rituximab
B. Plasmapheresis
C. Intravenous immunoglobulin
D. High-dose steroids
E. Splenectomy
Answer and topic summary
The answer is E. Splenectomy
Immune thrombocytopenic purpura (ITP) is an acquired thrombocytopenia caused by auto-antibodies against platelet antigens. Primary ITP is specifically due to autoimmune mechanisms, whereas secondary ITP is associated with other conditions or drugs. Some examples of causes of secondary ITP include systemic lupus erythematosus (SLE), HIV infection, hepatitis C infection, COVID-19, and thyroid dysfunction. Clinical symptoms include petechiae, purpura, easy-bleeding, bruising. Obviously platelets will be low. Work-up for ITP should include HIV and HCV testing, TSH, ANA, coagulation studies, and peripheral blood smear. A bone marrow biopsy can be done to rule out something more pathological. Treatment includes steroids (high-dose) and IVIG. Definitive treatment is splenectomy.
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Hematology ⇒ ⇒ ⇒
Also covered as part of the Internal Medicine EOR topic list
