[Immune thrombocytopenic purpura (ITP)]

Immune thrombocytopenic purpura (ITP) belongs to the major classical entities of clinical haematology. Diagnosis is still based on documentation of "megakaryocytic thrombocytopenia" and exclusion of other factors, diseases. The childhood (mainly acute) and adult type (mainly chronic) seem to differ substantially, and run different prognosis as well as response to therapeutic measures. A lasting remission or cure is uncommon with corticosteroids alone in the chronic cases, so splenectomy is frequently necessary and indicated. Standard therapy is poorly defined or established in splenectomy refractory cases, which situation requires experience, therapeutic skills and special care. There are many promising efforts to spare splenectomy, especially in younger patients. New standards are also recommended in ITP crisis situations (wet purpura, pregnancy and delivery, splenectomy, etc.). Standard as well as innovative approaches, focusing on clinical care, are briefly evaluated and reviewed in this report.