Chronic Idiopathic Thrombocytopenic Purpura

Predisposing factors/ Epidemiology

Highest in women from 15 – 50 years old.

Signs & Symptoms

Petechial hemorrhage, easy bruising, menorrhagia, mucosal bleeding like epistaxis or gum bleeding.


Usually idiopathic. Platelet antibodies causes the premature removal of platelets from the circulation by macrophages in the reticuloendothelial system especially the spleen. The antibodies are formed against glycoprotein (GP) IIb-IIIa or Ib complex.

Peripheral blood characteristics

Low platelet numbers and occasional large platelets are seen.

Bone marrow characteristics

Normal or increased number of megakaryocytes.

Important investigations & related results

Low platelet count with normal hemoglobin level and WBC count. Antiglycoprotein GPIIb/IIIa or GPIb antibodies on the platelet surface or serum can be detected.

Treatment & management

Corticosteroids, splenectomy, high dose of IV immunoglobulin therapy, immunosuppressive drugs, monoclonal antibodies: rituximab (anti-CD20), platelet transfusion or stem cell transplantation.

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