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ITP in Adults

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Autoimmune Thrombocytopenia

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Abstract

Most cases of adult ITP are chronic form, and the onset of the disease is usually insidious. Signs and symptoms vary widely in each case from no hemorrhagic symptom to severe life-threatening bleeding, such as intracranial hemorrhage. In addition to hemorrhagic symptom, treatment-related complications, such as infection and cardiovascular diseases, may lead to poor quality of life of ITP patients. Increase of thrombosis in ITP patients is also demonstrated in epidemiologic studies. Once diagnosed with ITP, screening and eradication of H. pylori should be performed in the regions of its high prevalence like Japan. After exclusion of H. pylori-associated ITP, treatment of ITP should be initiated to maintain safe platelet counts as a goal. First-line treatment is corticosteroids and second-line is splenectomy. For refractory ITP patients, thrombopoietin receptor agonists are highly recommended. Rituximab may be another option to get sustained response.

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Acknowledgment

This work was supported by Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology and the Ministry of Health, Labour and Welfare in Japan.

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Authors and Affiliations

  1. Department of Hematology and Oncology, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Hirokazu Kashiwagi M.D.

  2. Department of Blood Transfusion, Osaka University Hospital, 2-15 Yamadaoka, Suita, Osaka, 565-0871, Japan

    Yoshiaki Tomiyama M.D.

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  1. Hirokazu Kashiwagi M.D.
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  2. Yoshiaki Tomiyama M.D.
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Correspondence to Hirokazu Kashiwagi M.D. .

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Editors and Affiliations

  1. Division of Hematology and Oncology Department of Internal Medicine, Iwate Medical University School of Medicine, Morioka, Iwate, Japan

    Yoji Ishida

  2. Department of Blood Transfusion, Osaka University Hospital, Suita, Osaka, Japan

    Yoshiaki Tomiyama

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Kashiwagi, H., Tomiyama, Y. (2017). ITP in Adults. In: Ishida, Y., Tomiyama, Y. (eds) Autoimmune Thrombocytopenia　. Springer, Singapore. https://doi.org/10.1007/978-981-10-4142-6_7

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  • DOI: https://doi.org/10.1007/978-981-10-4142-6_7

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