• Evaluating thrombocytopenia
  • Always get blood smear - want to examine for schistocytes to rule out thrombotic thrombocytopenic purpura (TTP)
  • Immature platelet fraction - can show if patient is producing platelets at higher rate if it is elevated, hinting more at destructive process than at productive process
  
  If platelets are severely low, consider quinine-induced thrombocytopenia, ask about tonic water ingestion!
  
  Managing immune thrombocytopenic purpura (ITP)
  • If concerned for ITP but no active bleeding, hold off on transfusing platelets, even if count is low - platelets will just be destroyed
  • If platelets are given in evaluation, always obtain post-transfusion platetet count 1 hour after transfusion - if no response, likely ITP
  • No role for IVIG in the absence of significant bleeding
  • Steroids are always first-line therapy
    • 50 percent of patients relapse during steroid taper
  
  

  Posted 06/27/17 03:19:29 PM by Iheanacho (Obi) Emeruwa

• Severe bleeding events in adults and children with primary immune thrombocytopenia: a systematic review
  Initial Treatment of Immune Thrombocytopenic Purpura with High-Dose Dexamethasone
  High-dose dexamethasone vs prednisone for treatment of adult immune thrombocytopenia: a prospective multicenter randomized trial
  
  

  Posted 06/27/17 03:24:14 PM by Iheanacho (Obi) Emeruwa

Created by Christopher Kelly

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