Inclusion Criteria:  Patients with platelet less than 100 × 109/L diagnosed as immune thrombocytopenia according to bone marrow findings .  Exclusion Criteria:  Other causes of thrombocytopenia as:  Hypersplenism. Bone marrow diseases including : aplastic anemia, leukemia and myelodysplastic syndromes. Cancer treatments like chemotherapy and radiation therapy. Exposure to toxic chemicals as arsenic and benzene. Medications to treat bacterial infections (antibiotics)and treat seizures or blood thinner heparin.