Thrombocytopenia may result from decreased platelet survival, decreased production or sequestration in liver, spleen, or other sites. Along with lymphadenopathy, ITP is now recognized as a common manifestation of HIV infection. The exact cause of autoimmune ITP in HIV disease is not clearly understood, but it often reverses later in HIV infection.
Many patients are asymptomatic.
Patients may complain of gingival bleeding, rectal bleeding, epistaxis or the appearance of new bruises or red blotchy rash on the skin or palate. Check stool for guaiac. Most drug therapies provide temporary improvement at best. Consider low-dose radiation to spleen in patients who are poor surgical candidates. Monitor CBC with differential every 3-4 days, if any suspicion of active bleeding or oozing from nose, gums, etc.