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Question 10#

Primary ITP:

A. Occurs more often in children than adults, but has a similar clinical course
B. Includes HIT as a subtype of drug-induced ITP
C. Is also known as thrombotic thrombocytopenic purpura (TTP)
D. Is a disease of impaired platelet production, unknown cause

Correct Answer is B

Comment:

Primary immune thrombocytopenia is also known as idiopathic thrombocytopenic purpura (ITP). In children it is usually acute in onset, short-lived, and typically follows a viral illness. In contrast, ITP in adults is gradual in onset, chronic in nature, and has no identifiable cause. Because the circulating platelets in ITP are young and functional, bleeding is less for a given platelet count than when there is failure of platelet production. The pathophysiology ofiTP is believed to involve both impaired platelet production and T cell-mediated platelet destruction. Treatment of drug-induced ITP may simply entail withdrawal of the offending drug, but corticosteroids, gamma globulin, and anti-D immunoglobulin may hasten recovery of the count. HIT is a form of drug-induced ITP. It is an immunological event during which antibodies against platelet factor-4 (PF4) formed during exposure to heparin affect platelet activation and endothelial function with resultant thrombocytopenia and intravascular thrombosis.