Chronic immune thrombocytopenia
Chronic immune thrombocytopenia
Updated: 07/24/2023
© Jun Wang, MD, PhD
General features
- Typically in adults aged 20-40 years
- More common in women
- Usually do not have history of viral infection
- Associated with alterations in immune homeostasis
- Diagnosis of exclusion in patients with isolated thrombocytopenia
Clinical presentations
- Insidious onset, usually NO precipitating causes
- Most commonly bleeding in skin or mucosa
- Severe hemorrhage uncommon
- May have splenomegaly
Key pathogenesis
- Clonal expansion of CD8+ cytotoxic T cells may act independently of autoantibodies
- Autoantibodies against platelet GPIIb/IIIa or GPIb/IX
- Reduced platelet lifespan due to antibody-mediated destruction
- Impaired platelet production due to megakaryocytes damage
Key Laboratory findings
- Isolated thrombocytopenia
- Positive anti-platelet antibodies
- Negative anti-platelet tests could NOT rule out ITP
Key morphological features
- Normal to increased megakaryocytes
- Need to exclude myelodysplastic syndrome (MDS)
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