Immune Thrombocytopenic Purpura (ITP)

Platelet count drives the plan - Bleeding risk tracks the count; know it and its trajectory. For surgery, the count is often raised beforehand with steroids or IVIG.

Platelet transfusion timing - Transfused platelets are destroyed quickly, so they're given for active bleeding or just before and during surgery rather than prophylactically far ahead.

Neuraxial caution - Low counts raise the risk of spinal or epidural hematoma; weigh carefully against a count threshold.

Splenectomy specifics - A common definitive treatment; coordinate perioperative count optimization and watch for bleeding.

Steroids and IVIG - Patients may be on steroids (consider stress coverage) or recently given IVIG; know the regimen.

Immune thrombocytopenic purpura is autoimmune destruction of platelets, with impaired production, from antiplatelet antibodies — causing isolated thrombocytopenia with an otherwise normal coagulation system.

Bleeding risk rises as the count falls: mucocutaneous bleeding, purpura, and, when severe, serious hemorrhage. Treatments (steroids, IVIG, anti-D, thrombopoietin agonists, splenectomy) raise the count. Perioperatively the issue is the platelet count and bleeding risk, and — for splenectomy, a common surgery — getting the count up.