Primary immune thrombocytopenia: report of cases nonresponders to treatment

Abstract

Primary immune thrombocytopenia (ITP) is a rare pathology characterized by isolated thrombocytopenia
of autoimmune origin, with a platelet count <100 x109 / L not associated with a recognizable pathology,
with an increased risk of bleeding. There is no definitive confirmatory test to establish its diagnosis, which
is carried out mainly by exclusion. There is a small percentage of patients who do not respond to
conventional treatment. Refractory ITP refers to severe thrombocytopenia that persists after splenectomy,
while patients who meet criteria for severe ITP but who have not undergone splenectomy are considered
“non-responders” to the drugs used up to that time. Three clinical cases of severe, persistent and chronic
ITP, non-responders to treatment, are presented with the aim of pointing out the importance of a thorough
diagnostic investigation and the development of an effective combination of treatments for the management
of this complex pathology.