Acute immune thrombocytopenia

Acute immune thrombocytopenia 

Updated: 07/24/2023

© Jun Wang, MD, PhD

General features
  • Self-limited, usually weeks
  • Almost exclusively in children
  • Usually preceded by a viral infection (varicella, mononucleosis) or vaccination
  • Usually clinical diagnosis based on
Well appearing patient
Mucocutaneous bleeding
No systemic signs
Isolated thrombocytopenia
Clinical presentations
  • Sudden onset
  • Presentations depending on platelet count
  • Mild bleeding/petechiae, unless platelet < 20 x 103/mm3
  • NOT ITP if with lymphadenopathy or splenomegaly, usually suggestive of secondary thrombocytopenia
Key pathogenesis
  • May be associated with auto-reactive cytotoxic T cells, or autoantibodies against platelet membrane components
  • Probably due to exposure of cryptantigens or pseudoantigens
Key Laboratory findings
  • Isolated thrombocytopenia
Key morphological features
  • Megakaryocyte hyperplasia


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