Immune Thrombocytopenic Purpura and Henoch-Schönlein Purpura Management

Diagnostic Criteria

Immune Thrombocytopenic Purpura (ITP) is defined as isolated thrombocytopenia (platelet count <100 × 10^9/L) without other obvious causes, according to the American Society of Hematology 1, 2
Diagnosis of ITP is one of exclusion, requiring a normal peripheral blood smear except for reduced platelets, as recommended by the American Society of Hematology 3

Treatment decisions for ITP are based on bleeding risk rather than platelet count alone, as suggested by the American Society of Hematology 1, 5
First-line therapies for ITP include IVIg (0.8-1 g/kg), IV anti-D immunoglobulin (50-75 μg/kg) for Rh(D)-positive patients, and corticosteroids (prednisone 1-2 mg/kg/day) for short-term use, as recommended by the American Society of Hematology 6, 7

In children with ITP, spontaneous remission rates are high, with 74% in children <1 year, 67% in ages 1-6, and 62% in ages 10-20, according to the American Society of Hematology 8
Adult ITP is more likely to become chronic, with only 20-45% achieving complete remission by 6 months, as reported by the American Society of Hematology 8
Regular monitoring of platelet counts and bleeding symptoms is required for patients with ITP, as recommended by the American Society of Hematology 1

Secondary causes of ITP, such as HIV, HCV, and H. pylori, should be identified and treated, as suggested by the American Society of Hematology 5
Quality of life and fatigue are significant concerns for patients with ITP, especially in the first year after diagnosis, according to the American Society of Hematology 8
Platelet transfusions are generally ineffective except in emergency situations due to rapid destruction, as reported by the American Society of Hematology 5