Werlhof’s disease (idiopathic thrombocytopenic purpura, ITP)
| Description | Clinical presentation: Acute form mainly after viral infections, less commonly after taking medication and chronic form without recognizable cause. Thrombocyte count generally < 20.000/µl. In children usually acute onset and spontaneous remission within 6 months, in adults chronic form without remission. Obligatory evaluations: Full blood count, thrombocyte count in EDTA- and citrate- (or heparin-) blood, free thrombocyte-antibodies (2 ml serum) and fixed thrombocyte-antibodies (10 ml EDTA-blood, 20-30 ml in case of severe thrombopenia, autoantibodies are not always detectable), cardiolipin-antibodies (serum) Further evaluations in accordance with the suspected diagnosis: Bone marrow cytology, immunofixation, transaminases, coagulation, urine status, rheumatic disease-serology, infection serology (hepatitis A and B, parvovirus B19, EBV, CMV, HSV, HIV, measles, mumps, rubella, toxoplasmosis), HLA-DR2 (RR:9,2) Differential diagnosis (most important): Pseudo thrombocytopenia, medication-induced thrombocytopenia, secondary immune thrombocytopenia in autoimmune disorders, lymphoproliferative diseases and in infections |