Risk of Thrombosis in Patients With ITP

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Registry trials from Denmark and the United Kingdom have shown that patients with idiopathic thrombocytopenia purpura (ITP) have historically had an increased risk of thrombosis, notes Howard A. Liebman, MD. However, although thrombosis does commonly occurrs in patients with ITP, the event does not necessarily correlate with platelet count, Ivy Altomare, MD, adds. Thrombosis does not only occur in individuals with the highest level of platelets, making it difficult to assess when a patient is at risk.

Liebman comments that intravenous immunoglobulin, a treatment used in ITP, puts individuals at risk for arterial thrombosis, particularly in older patients. Inflammatory disorders are associated with the activation of the clotting system and an increased risk of thrombosis.

The cumulative risk of lifetime thrombosis is highest in patients who have undergone splenectomy, where the risk is 4 times higher, Altomare notes. Not only is there an inherent risk of thrombosis in ITP, but the therapies used affect the long-time risk, says Altomare. Liebman comments that these agents are capable of raising platelet counts to excessive heights.