Immune thrombocytopenic purpura (ITP) is an acquired autoimmune disorder characterized by isolated thrombocytopenia due to platelet destruction and impaired production. While global treatment guidelines exist, data on disease characteristics and treatment outcomes in resource-limited settings remain scarce.To describe the clinical characteristics, treatment responses, and adverse effects among ITP patients managed at Teaching Hospital Jaffna, Sri Lanka.A retrospective descriptive cross-sectional study was conducted among 154 patients diagnosed with ITP prior to March 2023, each with a minimum one-year follow-up. Data were extracted from medical records using a structured questionnaire. Definitions for diagnosis and response were based on International Working Group (IWG) criteria. Descriptive analysis was performed using SPSS version 23.The majority of patients were female (80.5%) and aged 18–60 years. Most (66.9%) were asymptomatic at diagnosis. Platelet counts <30 × 10⁹/L were observed in 42.9%, correlating with higher bleeding risk. First-line treatment with corticosteroids achieved a 76.2% complete response rate; IVIG resulted in 67.9% complete response. Relapse occurred in 54.5% of patients, with 73.2% of steroid-treated patients developing dependency. Splenectomy and eltrombopag, used as second-line treatments, achieved complete responses in 78.2% and 72.7% respectively. Steroid-related side effects were common; IVIG and eltrombopag were well-tolerated.ITP in this cohort was predominantly seen in adult females, with favorable acute treatment responses but significant relapse and steroid dependency. Second-line therapies were effective but not widely accessible. These findings emphasize the need for individualized management strategies and improved access to advanced therapies in resource-limited settings.
Pranja et al. (Thu,) studied this question.