Immune-mediated thrombocytopenia

IMTP

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Introduction

  • Immune-mediated thrombocytopenia (IMTP) is rare and poorly documented in the cat (in contrast to the dog).
  • Cause : most cases are likely to be secondary (particularly to FeLV infection and associated neoplasia) rather than primary autoimmune thrombocytopenia (AITP).
  • Signs : vague eg anorexia, lethargy.
  • Diagnosis : often presumptive, platelet count <50,000, anti-platelet antibody.
  • Treatment : treat underlying condition and immunosuppression if required.
  • Prognosis : guarded.

Diagnosis

Clinical signs

  • Ecchymotic hemorrhages of retina, iris and sclera.
  • Petechial hemorrhage of mucous membranes: mouth, sclera.
  • Petechial hemorrhages on skin - but coat may need to be clipped to see these.

Diagnosis

Differential diagnosis

Other causes of thrombocytopenia    .
  • Other bleeding disorders.

Outcomes

Prognosis

  • Must be guarded as underlying disease is often severe.
  • If underlying case can be identified and treated or response to treatment is rapid the prognosis may be favorable.

Expected response to treatment

  • Cessation of spontaneous bleeding if present.
  • Increasing platelet count.

Reasons for treatment failure

  • Underlying disease not diagnosed or treated adequately.
  • Therapy not sufficiently aggressive.
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