ITP: The Daily PANCE Blueprint
A 34-year-old female is diagnosed with immune thrombocytopenic purpura. What is NOT a known cause or risk factor of ITP?
A. Hepatitis C
B. Systemic lupus erythematosus
C. HIV
D. COVID-19
E. Warfarin
Answer and topic summary
The answer is E. Warfarin
Immune thrombocytopenic purpura (ITP) is acquired thrombocytopenia caused by autoantibodies 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. There are also many drugs that can lead to ITP, but warfarin is not known to be one of them. 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
