European Journal of Cardiovascular Medicine

Background:  The diagnosis of immune thrombocytopenia (ITP) is one of exclusion. Immune-mediated rapid platelet breakdown and decreased platelet production are its hallmarks. ITP can appear as a main (separate) condition or as a secondary condition in the context of other illnesses such autoimmune conditions and infections. Material & Methods: Study Design: A prospective and retrospective hospital based observational study. Study area: Department of Pathology, Government Medical College, Kadapa, Andhra Pradesh. Study Period: 1 year.  Study population:  The samples for the present study were collected from various clinical departments and wards like Medicine, Pediatrics, MICU and PICU. Sample size:  The study consisted of 60 cases. Study tools and Data collection procedure: Clinical history was collected from the patients and medical record files. Physical examination of the patients was done to see the clinical manifestations of the disease and to exclude other possible causes of present symptoms. Laboratory studies were conducted to diagnose Idiopathic Thrombocytopenic purpura. Blood was collected using standard phlebotomy procedures. Blood sample was processed in9 automated Hematology cell counter. Platelet count, Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) values were taken from the counter reading. Peripheral blood smear examination was done for all cases to look for thrombocytopenia lymphocytosis, eosinophilia and presence of blasts. Bone marrow aspiration/biopsy studies were done on selected patients to exclude other known causes of thrombocytopenia like those associated with leukemia, myelodysplasia etc. Indirect Immunofluorescence evaluation of presence of antiplatelet antibodies was performed in selective cases. Results: The most common presentation was with petechiae observed in 23 cases (39%) followed by ecchymoses (11cases,18%), epistaxis (09 cases,15%), hematuria (07 cases,12%) melena (05 cases,8%) and menorrhagia (05 cases,8%). Major serious hemorrhage like intracranial bleeding or hemopericardium was not seen. Conclusion: The majority of youngsters present with an abrupt onset of symptoms and a history of an earlier infection. Women who are childbearing age are the majority of those with chronic ITP. Isolated thrombocytopenia is the defining feature of ITP, and the presence of anaemia or neutropenia should raise the possibility that another illness may be the origin of the low platelet count.