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Idiopathic Thrombocytopenic Purpura, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Idiopathic thrombocytopenic purpura (ITP) is thrombocytopenia without apparent cause or abnormalities in other celllines.

  • Incidence is ∼2–5/100,000/yr—may be an underestimate owing to...

Diagnosis

Signs and Symptoms

History

  • Bleeding is the most common complaint:

    • Common:

      • Mucous membrane: Gingiva, epistaxis, conjunctival, menorrhagia

    • Rare (more common in coagulopathies):

      • GI bleeding, hemarthr...

Treatment

Pre-Hospital

Stabilize ABCs 
  • Significant oral or laryngeal bleeding may affect airway.

  • CNS event may affect ability to control airway

  • Establish IV access for cases of significant bleeding

  • Control...

Follow-Up

Disposition

Admission Criteria

  • Life-threatening bleeding regardless of platelet count

  • Any bleeding with platelet count <20 K

  • Asymptomatic patient with platelet count <20 K with issues of n...

Pearls and Pitfalls

  • Before low platelet counts are evaluated, pseudothrombocytopenia should be excluded.

  • Spontaneous bleeding usually does not occur until platelet counts are <10 K.

Additional Reading

  • British Committee for Standards in Haematology General Haematology Task Force. Guidelines for the investigation and management of idiopathic thrombocytopenic purpura in adults, chil...

Codes

ICD9

287.31 Immune thrombocytopenic purpura 

ICD10

D69.3 Immune thrombocytopenic purpura 

SNOMED

  • 32273002 Idiopathic thrombocytopenic purpura (disorder)

  • 28505005 acute idiopathic thrombocytopenic purp...

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