ITP:

E. Is in remission in more than 80% of patients with splenectomy.

DISCUSSION: ITP is characterized by a low platelet count and is definitively diagnosed by low platelet count in association with bone marrow that shows thrombasthenia. Patients with this illness experience abnormal bleeding during menstruation or nosebleeds or in response to minor insults. Occasionally, a patient who bleeds excessively after an auto accident is found to have undiagnosed ITP. The usual therapy is initiated with prednisone, and some believe that the prednisone response is predictive of success after splenectomy. Approximately 80% of patients, however, require increasing doses of steroids to maintain satisfactory platelet counts and ultimately require splenectomy. Similarly, approximately 80% of patients achieve normal platelet counts within 3 months after splenectomy, whereas more than 90% are remitted from further bleeding episodes.