Etiology, clinic, and current treatment options for immune thrombocytopenia: a review of the literature

Jurgita Zakaravičiūtė1, Vaida Vaitiekūnaitė1, Agnė Pinauskaitė1

1Lithuanian University of Health Sciences, Faculty of Medicine, Kaunas


Background. Immune thrombocytopenia (ITP) is an autoimmune disease defined by low platelet count and presents with an increased risk of bleeding. The diagnosis is based on the rejection of other potential diseases and the determination of platelet depletion. Observation alone, pharmacological or surgical treatment are possible dependent on the degree of thrombocytopenia.

Aim. To review the etiology, clinical manifestations, modern diagnostics and treatment options of immune thrombocytopenia.

Methodology. The topic has been analyzed in English publications in February 2022 – May 2022 in scientific databases: PubMed, UpToDate, Clinical Key using keywords: immune thrombocytopenia, coagulation disorders, pseudothrombocytopenia, hemorrhagic syndrome. Based on the exclusion criteria, the review was based on 18 scientific publications.

Results. Primary ITP is an autoimmune disease caused by autoantibodies to platelet membrane glycoproteins, secondary ITP is caused by comorbidities. Haemorrhagic syndrome occurs with platelet count < 30 × 109/l. The diagnosis is based on the denial of other pathologies that cause low platelet counts. With platelet count > 30 × 109/l, monitoring tactics are the most commonly used. The first choice drugs – glucocorticoids – are used in patients with platelet count < 30 × 109/l. If there is no response to initial treatment, thrombopoietin receptor agonists, immunomodulators or splenectomy should be administered.

Conclusions. Antibodies against platelets are the main reason of immune thrombocytopenia. Clinical manifestations of the disease depend on platelet count and can present in both asymptomatic and severe haemorrhagic syndrome. In mild cases, follow–up tactics are usually recommended and in the presence of severe disease, initial glucocorticoid therapy is the most commonly chosen treatment.

Keywords: immune thrombocytopenia, coagulation disorders, pseudothrombocytopenia, haemorrhagic syndrome.

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