• easy bruising
• epistaxis and menorrhagia common
• no systemic illness
• splenomegaly rare
• isolated thrombocytopenia
• other blood cells normal
• otherwise normal physical examination
• normal bone marrow with normal or increased megakaryocytes The two distinct types caused by immune destruction of platelets are:
• acute ITP: usually in children, often post-viral
• chronic ITP: autoimmune disorder, usually in adult women; all cases should be referred to a specialist unit
Chronic ITP rarely undergoes spontaneous remission and may require treatment with prednisolone. Some require splenectomy but this operation is avoided where possible, especially in young children, because of the subsequent risk of severe infection, particularly with Streptococcus pneumoniae. 4
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Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.