ITP

Itp

Small plt.  Wiskott aldrich

Large and small plt ITP

Large plt. Hereditary pseudo thrombocytopenia

Chronic ITP pt re dxed as wiskott A syndrome

Plt <150 is do of ITP

Dx of exclusion

Missed c is aplastic anemia and Wiskott A syn

Persistent ITP.  Do immunoglobulins before ivig

Bone marrow at 12 mo in ITP in child

Mucosal bleeding correlates with intracranial hge

Treat child only if symptomatic

No pt with plt >10 had micro hge in MRI

Hematuria incr risk of ich

Ich risk of Morty 25%

Fatigue can be a prominent part of ITP as plt go down

As gets older higher risk of bleeding

Chr ITP eltrombopag Rx

Some may have ana pos dat pos.  Autoimm phenotype

Rx also mmf

Ivig cause fever and headache.  Co treat with paracetamol and piriton

Eltrombopag can cause iron defy

Rx also romiplostin

Rx also rituximab

Ig in ITP are usually normal

Steroids cause most morbidity in ITP pts

Post vaxn ITP

ALPS pts may have hypogammaglobulinemia after rituximab

Splenectomy converts non responders to responders

Tpor agents.  Romiplostim. Eltrombopag

ROLE OF TRANEXAMIC ACID IN AC ITP

WISKOTT Aldrich bleed more than ITP

Wiskott Aldrich may just have mild eczema.  Small plt

X linked thrombocytopenia do well with splenectomy.  Wiskott a do not 

ITP with autoimmune disease.  Needs screening