الفهرس 
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Abstract
Primary immune thrombocytopenia (ITP) is a disease in which there is abnormal occurrence of thrombocytopenia due to unknown causes, but it seems that this disease occur due to antibodies founded due to abnormality in the immune system, these antibodies cause platelets breakdown which lead to marked decrease in their numbers, almost this disease is discovered accidentally or in CBC for any reason , we found that there is marked decrease in platelets number without any obvious symptoms which will lead to different forms of bleeding.
Disease symptoms vary according to bleeding form as:
- mucocutaneous bleeding involving the skin, oral cavity and gastrointestinal tract.
- Mucosal bleeding include epistaxis, menorrhagia, and gingival and gastrointestinal bleeding
- Intracranial hemorrhage is the most feared complication of ITP.
The cause of disease is always related to immunity abnormalities with appearance of antibodies against platelets , it is found in about 60% of cases, however there is other causes as taking some drugs as (antineoplastic drugs, sulfonamide compounds, sulfa, heparin and kinedine ) or infection by some viruses as (hepatitis B, hepatitis C , or some rheumatoid diseases as SLE)or sometimes it may be an early sign of leukemias or lymphomas.
Diagnosis is through CBC, and we should exclude any other diseases that lead to thrombocytopenia as hepatitis B, hepatitis C , and SLE ,in sometimes we need bone marrow sample.
Treatment is not necessary in mild cases, but in case of severe thrombocytopenia or bleeding treatment should be started with corticosteroids and intravenous immunoglobulin injections, or in case of non response to the previous treatment splenectomy is the solution for those cases ,platelets transfusion in cases of severe bleeding associated with thrombocytopenia can be one method of treatment.
Treatment selection also depends on platelets count ,for splenectomy as one of the methods of treatment for this disease we select it in case of fail of corticosteroids in treatment of thrombocytopenia but the operation results are not guaranteed as improvement may occur with rise in platelets count in 50-60%of cases who do the operation, partial improvement occur in 1 0% of cases, and no improvement in about 30% of cases , but splenectomy still the second line of treatment in ITP after corticosteroids failed treatment .