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ITP — RACP Adult Medicine MCQ

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EasyHaematologyITPRACP Adult Medicine

A 25-year-old woman presents with petechiae on her lower legs and mucosal bleeding (epistaxis, gum bleeding). Platelets are 8 × 10⁹/L. Hb and WCC are normal. Blood film shows reduced platelets but otherwise normal. Coagulation is normal. Anti-platelet antibodies are present. She has no splenomegaly. What is the most likely diagnosis?

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Correct answer: B — Immune thrombocytopenia (ITP)

Isolated severe thrombocytopenia (<20 × 10⁹/L) with mucosal bleeding, normal other cell lines, normal coagulation, and anti-platelet antibodies is immune thrombocytopenia (ITP). It is a diagnosis of exclusion. Treatment: prednisolone 1 mg/kg (first-line), IVIG (if rapid response needed or bleeding), and anti-D (if Rh-positive). Second-line: rituximab, TPO-RA (eltrombopag, romiplostim), or splenectomy.

Reference: BSH – 2024 – ITP; ASH 2024 ITP