How to manage ITP with life-threatening bleeding

While immune thrombocytopenia often presents with mild bleeding manifestations or surprising findings of thrombo cy to pe nia on rou tine com plete blood counts in patients with out symp toms, some patients can pres ent with new thrombocytopenia and life-threatening bleeding. Emergent assessment and treatment are needed to prevent substantial mor bid ity and even mor tal ity. These patients pres ent to the emer gency room with bleed ing, and hema tol o gists are sub se quently consulted. Understanding the approach to mak ing the diag no sis and exclud ing other life- threat en ing illnesses is essen tial, as is rapid ini ti a tion of treat ment in the bleed ing patient even when the diag no sis of immune- medi ated throm bo cy to pe nia is ten ta tive. Using a case- based for mat, we review how to approach and treat patients presenting with new thrombocytopenia and bleeding.