Immune Thrombocytopenia (ITP)

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Authors: Mohanad Abdelmagid / Editor: Tadgh Moriarty / Codes: / Published: 14/06/2024

Immune thrombocytopenia (ITP) is a medical condition characterized by a decrease in platelet count in the absence of abnormalities in the bone marrow and other identifiable causes of low platelet levels. This disorder presents itself in two distinct clinical forms, with an acute manifestation primarily observed in children, and a chronic variant more prevalent among adults.

This module encompasses the evaluation and treatment of individuals who are either identified as having or presenting to the Emergency Department (ED) with signs and symptoms of Immune Thrombocytopenia (ITP).

Learning objectives

After completing this session, you will be able to:

  • Develop proficiency in managing patients with Immune Thrombocytopenia (ITP) in the Emergency Department.
  • Acquire a comprehensive understanding of the pathophysiological mechanisms and etiological factors underpinning Immune Thrombocytopenia (ITP).
  • Conduct an in-depth analysis of the workup essential for the assessment and diagnosis of Immune Thrombocytopenia (ITP).
  • Convey a concise and comprehensive overview of the therapeutic modalities available for the management of Immune Thrombocytopenia (ITP), with a specific emphasis on the emergency care setting.

References

  1. Terrell DR, Beebe LA, et al. The incidence of immune thrombocytopenic purpura in children and adults: A critical review of published reports. Am J Hematol. 2010 Mar;85(3):174-80.
  2. Schoonen WM, Kucera G, Coalson J, et al. Epidemiology of immune thrombocytopenic purpura in the General Practice Research Database. Br J Haematol. 2009 Apr;145(2):235-44. [Erratum in: Br J Haematol. 2009 Sep;147(1):157.]
  3. Neunert C, Terrell DR, Arnold DM, et al. American Society of Hematology 2019 guidelines for immune thrombocytopenia. Blood Adv. 2019;3(23):3829-3866.
  4. Nugent D, McMillan R, Nichol JL, et al. Pathogenesis of chronic immune thrombocytopenia: increased platelet destruction and/or decreased platelet production. Br J Haematol. 2009;146:585-596.
  5. McKenzie CG, Guo L, Freedman J, et al. Cellular immune dysfunction in immune thrombocytopenia (ITP). Br J Haematol. 2013;163:10-23.
  6. Segal JB, Powe NR. Prevalence of immune thrombocytopenia: analyses of administrative data. J Thromb Haemost. 2006;4:2377-2383.
  7. Scaradavou A, Woo B, Woloski BM, et al. Intravenous anti-D treatment of immune thrombocytopenic purpura: experience in 272 patients. Blood. 1997 Apr 15;89(8):2689-700.
  8. Carr JM, Kruskall MS, Kaye JA, et al. Efficacy of platelet transfusions in immune thrombocytopenia. Am J Med. 1986 Jun;80(6):1051-4.
  9. Immune thrombocytopenia – Investigations | BMJ Best Practice [Internet]. Last reviewed 2024.
  10. Immune thrombocytopenia – Treatment algorithm | BMJ Best Practice [Internet]. Last reviewed 2024.
  11. Justiz Vaillant AA, Gupta N. ITP-Immune Thrombocytopenic Purpura. [Updated 2024 May 5]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.
  12. OHara S. EM@3AM: Idiopathic thrombocytopenic purpura [Internet]. emDOCs.net – Emergency Medicine Education. 2018.
  13. Idiopathic thrombocytopenic purpura [Internet]. Core EM.
  14. Silverman MA. Immune thrombocytopenia (ITP) in Emergency Medicine Clinical presentation: History, physical examination [Internet]. Updated: 2023.

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