[Rosen - ITP](x-devonthink-item://F3C647AF-B411-4C79-AA85-8C42F04A7DFC?page=6&istart=1014&ilength=22&search=Immune%20Thrombocytopenia), [RCH - ITP](x-devonthink-item://28044A61-86F6-4D02-8CD4-C7D4793841DD) - most common cause of [[thrombocytopaenia]] in patients not on heparin who have no features of other disease - plt destruction due ot adsorption of anti-viral antigen - 5% of pts present with severe bleeding **DDx** - drug-induced thrombocytopenia - HIV - hep C - H pyloria **children** - peak incidence 5 years old - sudden onset of petechiae / purpura in an otherwise well child - infecitous illenss in previous weeks as precipitant **adults** - more gradual onset than in chldren - infectious precipitants: - EBV - rubella - CMV - viral hepatitis # management - often not required in children due to excellent prognosis - \>50% recover within 4 weeks without treatment - \>80% recover in 6 months > target platelet count following treatment: > \>25,000 > \>50,000 in pts on anti-coagulants or anti-platelet agents **Rx** - prednisolone - if plt <50 - 1mg/kg - rituximab - anti-d immunoglobulin - in Rh positive children with plt <30 - 75 mcg/kg - don't use in pts with splenectomy - IVIG plt < 10 **Life threatening haemorrhage** - plt transfusion -- usually only lasts a few hours without other therapieis - IV steroids - consider TXA