🩺 General MedicineHaematologyStudentInternResident

Immune Thrombocytopenia (ITP)

Also known as: ITP · immune thrombocytopenic purpura · idiopathic thrombocytopenic purpura

Immune-mediated destruction of platelets causing isolated thrombocytopenia — bruising, petechiae and mucosal bleeding with an otherwise normal blood count and film. It is a diagnosis of exclusion.

Source · Reviewed 2026-08-15 · v1.0— AI-assisted draft — verify against the cited guideline before clinical use.

⚕️ Education only — not medical advice. Verify against the latest official guideline and your local protocol; confirm every drug dose against the cited source before clinical use.

Who gets it

Children (often acute, post-viral and self-limiting) and adults (often chronic); also secondary to infection (HIV, hepatitis C, H. pylori), autoimmune disease, or drugs.

Red flags — escalate / refer

Major bleeding (intracranial, gastrointestinal), very low platelets with 'wet' purpura (mucosal bleeding), or a rapidly falling count → urgent treatment.

Work-up / diagnosis

1Isolated low platelets with a normal film (exclude pseudothrombocytopenia and other cytopenias).
2A diagnosis of exclusion — screen for secondary causes (HIV, hepatitis C, H. pylori) and review drugs; bone marrow only if atypical.

Management — overview

Many children and mildly-affected adults need only observation.
Treat based on bleeding and platelet level, not the number alone — first-line corticosteroids, or IV immunoglobulin for a rapid rise or active bleeding.
Platelet transfusion only for life-threatening bleeding (with IVIG/steroids).
Second-line: thrombopoietin-receptor agonists, rituximab or splenectomy; treat any secondary cause.

In-depthFull dosing & advanced protocol

Drug dosing

Corticosteroids (first-line) / IVIG

Raise the platelet count

Adult dose: Steroid course; IVIG for rapid rise or active bleeding — per protocol
Route: Oral / IV

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

TPO-receptor agonist / rituximab (second-line)

Refractory or chronic ITP

Adult dose: Per protocol
Route: Oral / SC / IV

WHOWHO Model List of Essential Medicines (electronic EML) (2025 (24th)) ↗

Treat the bleeding, not the number

Transfused platelets are rapidly destroyed — reserve for major bleeding alongside immunotherapy.
Always look for a secondary cause (HIV, hepatitis C, H. pylori, drugs).
Steroids are first-line but avoid prolonged courses.

ICMRStandard Treatment Workflows (STWs), India — Dept. of Health Research & ICMR (2022+) ↗

References

Guidelines change. If something here is out of date, tell us — we keep these current.

🚩 Report outdated / suggest update

More protocols

HypertensionPersistently raised arterial pressure (≥140/90 mmHg) — a leading, modifiable cause of stroke, heart attack, heart failure and kidney disease.DengueAn Aedes-borne viral febrile illness. Most cases self-limit, but plasma leakage can cause severe dengue — early recognition of warning signs and careful fluid therapy save lives.MalariaA mosquito-borne protozoal (Plasmodium) febrile illness. In India P. vivax and P. falciparum predominate; prompt diagnosis and species-specific treatment prevent severe disease.

Loading…

👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Corticosteroids (first-line) / IVIG

TPO-receptor agonist / rituximab (second-line)

📈 Treat the bleeding, not the number

📚 References

More protocols

👤 Who gets it

🚩 Red flags — escalate / refer

🔎 Work-up / diagnosis

🧭 Management — overview

💊 Drug dosing

Corticosteroids (first-line) / IVIG

TPO-receptor agonist / rituximab (second-line)

📈 Treat the bleeding, not the number

📚 References

More protocols

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Treat the bleeding, not the number

References

Who gets it

Red flags — escalate / refer

Work-up / diagnosis

Management — overview

Drug dosing

Treat the bleeding, not the number

References