Immune Thrombocytopenia (ITP)
Hematology · ~5% of blueprint- Pathophysiology
- Autoantibody-mediated platelet destruction → isolated thrombocytopenia.
- Signs & Symptoms
- Mucocutaneous bleeding — petechiae, purpura, easy bruising, epistaxis; otherwise well-appearing.
- Gold Standard Diagnosis
- Isolated low platelets with normal WBC/Hgb and an otherwise normal smear (diagnosis of exclusion).
- First-line Treatment
- Observe if platelets ≥30k with minor or no bleeding; otherwise corticosteroids (±IVIG). ASH 2026 suggests adding rituximab or a TPO agent up front; after steroids, a TPO agent (strong) or rituximab.
Drug cardsPrednisone
High-Yield Pearl
ITP = isolated thrombocytopenia with an otherwise normal CBC & smear (a diagnosis of exclusion).
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Sources
Reviewed September 2026- American Society of Hematology 2026 Guidelines for Immune Thrombocytopenia: Initial and Second-Line Therapy in Adults with Primary ITP — American Society of Hematology, 2026
- American Society of Hematology 2019 guidelines for immune thrombocytopenia — American Society of Hematology, 2019
- StatPearls: Immune Thrombocytopenia — StatPearls Publishing / NCBI Bookshelf, 2026
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