Which physical findings indicate the severity of immune thrombocytopenia (ITP)?

Updated: Jan 11, 2020
  • Author: Craig M Kessler, MD, MACP; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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Answer

An initial impression of the severity of ITP is formed by examining the skin and mucous membranes, as follows:

  • Widespread petechiae and ecchymoses, oozing from a venipuncture site, gingival bleeding, and hemorrhagic bullae indicate that the patient is at risk for a serious bleeding complication.

  • If the patient's blood pressure was taken recently, petechiae may be observed under and distal to the area where the cuff was placed and inflated.

  • Suction-type electrocardiograph (ECG) leads may induce petechiae.

  • Petechiae over the ankles in ambulatory patients or on the back in bedridden ones suggest mild thrombocytopenia and a relatively low risk for a serious bleeding complication.


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