Presentation

Signs and Symptoms

• Petechiae (< 1 cm)
• Purpura (> 1 cm)
• Nose bleed (Epistaxis ), gum bleed
• **Check mouth as petechiae in the mouth has a strong association with intracranial spontaneous hemorrhage

Pathogenesis

Risk factors

Classifications

Differential

Investigation

Tests available:

Decision:

Management

First Line

• Prednisone (systemic steroid) - First line
  • expect imporve in 2-7 d
• + IVIG - severe ITP & active bleeding
  • act faster than steroid
  • work by occupies the Fc receptor.
    • IVIG saturates the Fc receptor of the splenic macrophage, so that the platelets are not destructed.
• + Platelet transfusion - significant bleeding (e.g. intracranial & GI bleeding)

Second Line