Thrombocytopenic Purpura in Adults

Overview

Idiopatic thrombocytopenic purpura is one of the basic clinical entities characterized above allby thrombocytopenia. It is an autoimmune disease caused by antibodies against glycoproteinsof the thrombocyte membrane, most frequently GP IIIa/IIb and GP Ib/IX. In addition to basiclaboratory examinations (haemogram, biochemistry) as well as special examinations such assternal puncture, the diagnosis is supplemented by immunocytoflowmetry and MAIPA withdetection of antibodies against thrombocytes and examinations of thrombocyte survival. By useof further laboratory examination (haemogram in oxalate) it is important to differentiate ITPfrom „pseudothrombopenia“. Secondary autoimmune thrombopenia can be ruled out by laboratory tests used to diagnose systemic diseases, thyroid disorders, paravirus thrombopenia etc.For the diagnosis of other secondary thrombopenias incl. those caused by hypersplenism oraffection of the bone marrow by another, most frequently malignant disease, a number oflaboratory and imaging methods are used.In addition to summarizing diagnostic possibilities of ITP the authors analyze therapeuticpossibilities - starting with corticoid treatment, and in serious haemorrhage large doses ofimmunoglobulins to second line treatment such as splenectomy, and refractory forms of thedisease and the authors draw attention to undesirable effects of some non-conventionaltherapeutic protocols.

Key words:
idiopathic thrombocytopenic purpura - immunoglobulins - corticoids - splenectomy- MAIPA.