AUTOIMMUNE THROMBOCYTOPENIA PURPURA - PATHOGENESIS, DIAGNOSIS AND MANAGEMENT

Autoimmune thrombocytopenia purpura (AITP) is a common haematological disorder caused by antiplatelet autoantibodies that lead to increased clearance of platelets by the reticuloendothelial system. Patients wit h AITP have low platelet counts and a bleeding tendency affecting the skin and mucosa. AITP can be classified into 2 main clinical syndromes : (a) idiopathic (primary or essential) thrombocytopenia (ITP) and (b) secondary AITP. Secondary AITP occurs in conjunction with a primary ( usually autoimmune or malignant) disorder, and accounts for the majori ty of cases of AITP. ITP has an unknown aetiology, and diagnosis is ma de by exclusion of secondary AITP. Laboratory diagnosis of AITP relies on detection of platelet-associated immunoglobulin or on the demonstr ation of platelet autoantibodies that react with specific target antig ens on the platelet surface. Treatment of AITP involves therapy with c orticosteroids, followed if necessary by splenectomy. The use of high- dosage intravenous immunoglobulin G may improve the response to cortic osteroids.