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Immune Thrombocytopenic Purpura

Immune thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by low platelet count and mucocutaneous bleeding. The disorder occurs in approximately 50 adults per 1 million persons annually. It is classified as acute (<6 months duration) or chronic and can occur as a primary disease or secondary to another disorder, such as human immunodeficiency virus (HIV). In adults, ITP is often chronic and insidious in onset, occurring twice as frequently in women as men. In children, boys and girls are equally affected. Currently, the diagnosis of ITP is one of exclusion.3

Treatment Options for ITP

Some of the options available for treating ITP include corticosteroids, anti-D immune globulin (WinRho SDF®), intravenous immune globulin (IVIG), splenectomy, and vinca alkaloids. There are risks associated with each of these treatments.

Treatment Option Associated Risks
Steroids2 Lower resistance to infection, behavioral changes, weight gain, swelling & redistribution of body fat. Long-term use: risk of GI bleeding, cataracts, glaucoma, and osteoporosis
WinRho SDF®
(anti-D immune
Risk of transmission of infectious agent, anaphylaxis, renal insufficiency, intravascular hemolysis, anemia
Intravenous Immune Globulin (IVIG)4 Risk of transmission of infectious agent, renal dysfunction, acute renal failure, osmotic nephrosis, death, pulmonary insufficiency
Danazol3 Hepatotoxicity, rash, and masculinization
Splenectomy5,6 Surgical procedure with attendant risks; results may not be permanent5 Lifelong risk of overwhelming infection6 (defined as septicemia and/or meningitis)

Risk of impaired liver function, potential risk of carcinogenicity
Vinca Alkaloids3 Low, transient response rate (3-30%) often complicated by neuropathy
Cyclophosphamide3 Marrow suppression, hemorrhagic cystitis, fibrosis of the bladder, myeloid leukemia, alopecia, infertility, and possible teratogenicity





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