Devasena Srinivasan 1 , Suja Lakshmanan 2 , Saketh Vulchi 3 , P. Sathyamurthy 4 , M. K. Sudhakar 5 , P. V. Bhaskar Reddy 6
ABSTRACT: BACKGROUND: Idiopathic Thrombocytopenic purpura is relatively uncommon. It is always diagnosis of exclusion. The demographics of Idiopathic Thrombocytopenic purpura can be very varied. Corelation between platelet count and bleeding manifestations and response to therapy have not been clearly established. AIM: The aim of the study was to study the demographics of Idiopathic Thrombocytopenic Purpura in the south Indian population and to analyze the possible relationship between platelet levels, clinical manifestations and response to treatment. MATERIALS AND METHODS: A prospective study was carried out for two years which included all adults with diagnosis of idiopathic thrombocytopenic purpura. Parameters noted were clinical features with emphasis on site of bleeding. Platelet counts on admission were noted. This was monitored regularly till the time of discharge from hospital.Treatment of all patients was with intravenous methyl prednisolone. Some patients also received intravenous immunoglobulin. RESULTS: Sixty patients were included in the study. Patients with average platelet count of more than 60,000 per cubic millimeter did not have bleeding. 63.3 percent of patients presented with bleeding manisfestations. The average platelet count in the group was 26,605 per cubic millimeter. Most common bleeding manifestation was bleeding gums followed by cutaneous bleeding. 61.7 percent had complete response to treatment, 17.3 percent had partial response and 30 percent had poor response. 8.5 percent underwent splenectomy. Mortality rate was five percent. These patients had average platelet count of less than 15000 cells per cubic milliliter. CONCLUSION: Identification of common clinical presentation and their relationship to platelet count helps identify patients who are at increased risk for fatal bleeding diathesis.
