IDIOPATHIC THROMBOCYTOPENIC PURPURA - DIAGNOSIS AND MANAGEMENT

Idiopathic thrombocytopenic purpura (ITP, also known as immune thrombo cytopenic purpura) in adults is principally a disease of young women. Although in some patients the onset is acute and complete resolution o ccurs, in most patients, the onset is insidious and the course is chro nic. In spite of the relative frequency of ITP, there are important un resolved issues in its diagnosis and management. For this reason, the American Society of Hematology (ASH) chose ITP as the disease topic fo r its initial sponsored practice guideline in 1993. A major conclusion of the published guideline was the lack of firm evidence on which to base diagnostic procedures and management strategies. This review desc ribes the clinical features of ITP in adults, emphasizes the principal unresolved issues in diagnosis and management, and outlines the criti cal areas for future research.