Friday, 17 September 2010

MRCP revision battle 14.5: Idiopathic Thrombocytopenia Purpura

ITP is a condition which results in low numbers of platelets.  Despite its title of 'idiopathic' it is often autoimmune mediated, with IgG autoantibodies against glycoprotein IIb/IIIa/Ib complex.

Acute ITP:
  • affects mainly children
  • boys and girls equally affected
  • often after infection/vaccination
  • tends to be self-limiting over 2 weeks

Chronic ITP:
  • females >males
  • relapsing-remitting

In ITP the bone marrow shows megakaryocytes

Treatment is only needed if the patient is symptomatic or the platelets are <20.
First line = oral prednisolone - 80% respond
If no response in 3 months --> splenectomy
Other options include IV IG or immunosupressive drugs.

One random MRCP type syndrome: Evan's syndrome = ITP +AIHA.

Nearly there, just a quick tricyclic overdose to go...