I Bacteria

II viruses

III Others: Parasitic infection

It is mainly caused by allergies caused by animal proteins, such as fish, shrimp, crab, milk, etc.

1) Antibiotics

2) Antipyretic and analgesic drugs

3) Other drugs

4) Others: pollen, dust, etc.

1) Most common

2) Mainly manifested as skin purpura, limited to the limbs

3) Purpura often appears repeatedly in batches, is symmetrically distributed, and varies in size. In severe cases, it can merge into bullae with hemorrhagic necrosis in the center.

4) May be accompanied by skin edema, urticaria, etc.

1) In addition to skin purpura, the gastrointestinal mucosa and peritoneal visceral capillaries are affected

2) Symptoms include abdominal pain, diarrhea, vomiting, and blood in the stool. Abdominal pain is the most common, often paroxysmal colic.

3) In children, intussusception may be induced due to intestinal wall edema and intestinal peristalsis disorder.

1) In addition to skin purpura, due to blood vessel involvement in the joints

2) Symptoms such as joint swelling, pain, tenderness and dysfunction

3) Symptoms of migratory and recurrent attacks, which heal after a few days without leaving any joint deformity.

1) The most serious

2) On the basis of skin purpura, hemorrhagic glomerular capillary loop inflammatory reaction

3) Symptoms include hematuria, proteinuria and cast urine, and occasionally edema, hypertension and renal failure.

Skin purpura combined with more than two of the above clinical manifestations

A few cases may also involve the eyes, brain and meningeal blood vessels, causing optic atrophy, iritis, retinal hemorrhage and edema, as well as central nervous system symptoms and signs.

I Routine blood tests

II Routine examination of urine and stool

III Capillary fragility test: half positive

Bleeding time (BT) can be prolonged

1) There is often a history of low-grade fever, sore throat, general fatigue or upper respiratory tract infection 1 to 3 weeks before the onset of illness

2) Typical purpura on the skin of the limbs, which may be accompanied by abdominal pain, joint swelling and pain, and hematuria

3) Platelet count, function and coagulation-related tests are normal

4) Exclude vasculitis and purpura caused by other causes

1) Hereditary telangiectasia

2) Simple purpura

3) Primary immune thrombocytopenia

4) Rheumatoid arthritis

5) Glomerulonephritis

6) Systemic lupus erythematosus

7) Surgical acute abdomen, etc.

1) Prevent infection

2) Clear local lesions

3) Get rid of intestinal parasites

4) Avoid foods and drugs that may cause allergies

I General processing

II antihistamines

III Drugs that improve vascular permeability

1) Mainly used for patients with joint swelling and pain, severe abdominal pain combined with gastrointestinal bleeding, and patients with severe kidney disease such as rapidly progressive nephritis or nephrotic syndrome.

2) Inhibit antigen-antibody reactions, reduce inflammatory exudation, and improve vascular permeability

3) The general course of treatment does not exceed 30 days, but may be extended as appropriate for renal-type purpura.

1) Abdominal pain: atropine or anisodamine

2) Joint pain: use painkillers as appropriate

3) For severe vomiting: antiemetics

4) People who vomit blood or bloody stools: Omeprazole, etc.

I Immunosuppressants: azathioprine, cyclosporine, etc.

II Anticoagulant Therapy: Suitable for Renal Type Patients

III Chinese medicine: mainly cooling blood, detoxifying, activating blood circulation and removing blood stasis, suitable for patients with chronic recurring attacks and kidney type

a Extensive bleeding of skin, mucous membranes and internal organs

b Peripheral blood thrombocytopenia

c Bone marrow: Megakaryocyte development and maturation disorder

d PLT autoantibodies appear and PLT survival time is shortened

1) Insidious onset

2) Often manifested by repeated bleeding of skin and mucous membranes such as petechiae, purpura, ecchymosis, and difficulty in stopping bleeding after trauma, etc.

3) Fatigue is another common clinical symptom of ITP

4) Excessive bleeding or long-term menorrhagia may cause blood loss anemia

1) Skin purpura or ecchymosis, most common on the distal ends of the limbs

2) Mucosal bleeding is more common with nose bleeding, gum bleeding or oral mucosal blood blisters.

3) Generally there is no enlargement of liver, spleen or lymph nodes

1) Decreased platelet count

2) The average platelet volume is too large

1) Normal coagulation function

2) Prolonged bleeding time

Bone marrow megakaryocyte count is normal or increased

megakaryocyte maturation disorder

1) Check the platelet count at least twice, and there is no abnormality in the blood cell morphology.

2) Physical examination shows that the spleen is generally not enlarged

3) The number of megakaryocytes in bone marrow examination is normal or increased, and there is maturity disorder.

4) Exclude other secondary thrombocytopenias

1) Pseudothrombocytopenia

2) Secondary thrombocytopenia: aplastic anemia, hypersplenism, leukemia, etc.

1) Newly diagnosed ITP: refers to ITP patients within 3 months after diagnosis

2) Persistent ITP: refers to ITP patients with sustained thrombocytopenia 3 to 12 months after diagnosis.

3) Chronic ITP: refers to ITP patients whose thrombocytopenia lasts for more than 12 months

4) Severe ITP: refers to platelets <10×10∧9/L, and there are bleeding symptoms that require treatment at the time of treatment or new bleeding symptoms occur during routine treatment, and other platelet-raising drugs or drugs that increase existing treatments need to be used. dose

5) Refractory ITP

1) PLT<20×10^9/L, strict bed rest to avoid trauma

2) Application of hemostatic drugs and local hemostasis

If the platelet count is higher than 30×10^9/L, there is no surgery or trauma, and the patient is not engaged in work or activities that increase the risk of bleeding, generally no treatment is required, and observation and follow-up are possible.

I Glucocorticoids

II Intravenous infusion of immunoglobulin (IVIg)

For patients whose first-line treatment is ineffective or who require larger doses of glucocorticoids (>15 mg/d) for maintenance, second-line treatment can be selected.

I Medication

II Splenectomy

I Platelet transfusion

II Intravenous infusion of gamma globulin (IVIg)

III High dose methylprednisolone

IV thrombopoietic drugs

V Recombinant human activated factor VII (rhF VIIa)