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Abstract

Introduction: ITP is an autoimmune cytopenia common in adults. The hemorrhagic risk may involve a vital prognosis.Its management is still poorly codified.We studied the diagnostic characteristics of ITP and evaluated its therapeutic management and its evolutionary profile in adults. Materials and Methods: this is a retrospective study of 55 cases of ITP, conducted over 21 years (January 2000 to December 2020). Results:The average age of patients was 44 years with a clear female predominance (sex ratio 3.5). The circumstance of discovery was fortuitous in 41.8% of cases and following hemorrhagic syndrome in 34.5% of cases. Deep thrombocytopenia (< 30,000 el/mm3) was found in 42.8% of cases. The presence of bleeding was correlated with the depth of thrombocytopenia. Antinuclear antibodies were positive in 76% of cases. Corticosteroid therapy was prescribed first-line in 50.9% of patients. A response was obtained in 78.6% of cases. Splenectomy was performed in 12.7% of cases. The response rate was 57.1%. Four patients benefited from rituximab with an initial response observed in all cases. The trend towards chronicity was observed in 78.2% of cases. Conclusion: ITP is a diagnosis of exclusion. It is mostly moving towards chronicity.Treatment is mainly based on corticosteroid therapy. Surveillance may be sufficient in the presence of hemostatic platelets. Splenectomy keeps room but is increasingly delayed after the advent of new therapies.