Anaesthesia recommendations for patients suffering from Immune thrombocytopenia (ITP)

Immune thrombocytopenia, previously known as idiopathic thrombocytopenic purpura (ITP), is an autoimmune disease that is related to anti-platelet immunoglobulin (IgG) production. The production of IgG autoantibodies is critically dependent on cellular immune mechanisms particularly relating to T cells. The production of these autoantibodies by B cells depends on a number of cellular mechanisms that form a network of modulation, with T cells playing a pivotal role in pathophysiology. T-cell-mediated cytotoxicity is an alternative mechanism for platelet destruction in ITP [1-3]. Other causes are included genetic factors (immune genes- FcR, immune syndromes, platelet antigens) and susceptibility to initial event (infection, inflamination) [4]. Immune thrombocytopenia is characterised by increased mucocutaneous haemorrhage risk with low platelet counts [5].