What are the demographics of chronic immune thrombocytopenia (ITP)?

Updated: Nov 30, 2019
  • Author: Perumal Thiagarajan, MD; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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This condition is typically observed in adults aged 20-40 years. It has an insidious onset, and a history of an antecedent infection need not be present. Unlike childhood ITP, chronic ITP is more common in females than in males. As in childhood ITP, the bleeding manifestations depend on the platelet count. [4, 5, 6]

The diagnosis of ITP is established by the exclusion of other causes of thrombocythemia. The peripheral blood film should be examined to rule out thrombotic thrombocytopenic purpura (TTP) (fragments) or spurious thrombocytopenia resulting from clumping (see image below).

Spurious thrombocytopenia. Peripheral smear of a p Spurious thrombocytopenia. Peripheral smear of a patient reported to have platelet counts of 10,000-150,000/μL on various occasions. The smear shows clumping of the platelets and satellitism involving neutrophils and platelets.

Often, the smear shows giant platelets, which is a reflection of the increased thrombopoietin-induced stimulation of bone marrow. Bone marrow examination, which is not always necessary, shows increased megakaryocytes.

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