What is the focus of the clinical history in the evaluation of suspected immune thrombocytopenia (ITP)?

Updated: Dec 14, 2019
  • Author: Michael A Silverman, MD, MD; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
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Answer

Focus on the symptoms of bleeding (eg, type, severity, duration) and on symptoms that may exclude other causes of thrombocytopenia. Elicit risk factors for HIV and systemic symptoms linked to other illnesses or to medications (eg, heparin, alcohol, quinidine/quinine, sulfonamides) that may cause thrombocytopenia.

Medications can be a common etiology for inducing thrombocytopenia, and patients should have their medications carefully reviewed. One study used three distinct methods to document drugs that may be associated with drug-induced immune thrombocytopenia (DITP). [3, 4] Approximately 1500 drugs are associated with thrombocytopenia, but, using this analysis, 24 drugs had evidence of causing thrombocytopenia by all three methods.

Address risk factors for increased bleeding, such as GI disease, CNS disease, urologic disease, or active lifestyle, as these may determine the aggressiveness of management.


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