Alternate considerations for current concepts in ITP

Immune thrombocytopenia (ITP) is one of the most common forms of autoimmune disease affecting both adults and children. In recent years, there have been tremendous developments in the understanding of the pathogenesis and treatment of this condition. However, certain concepts related to ITP are worth consideration in view of alternative explanations and evidence available. These include (i) ITP is a disorder where thrombocytopenia is induced by autoantibodies against platelets or megakaryocytes, (ii) the mechanism of action of corticosteroids in ITP is through suppression of these autoantibodies, (iii) splenectomy is effective in ITP since spleen is the site of platelet destruction, and (iv) splenectomized ITP patients are at a major risk of infections.