Secondary ITP in adults

Secondary forms of immune thrombocytopenia (ITP) represent approximately 20% of all ITP cases in adulthood and this rate increases with age. Since some causes may influence both the prognosis and outcome but also the management of ITP, a minimal workup must be performed at ITP diagnosis to look for an associated or underlying cause. Among adults, B-cell lymphomas and mainly chronic lymphocytic leukemia, systemic auto-immune diseases such as systemic lupus or primary immunodeficiencies mainly represented by common variable immunodeficiency are the most frequent causes of secondary ITP. Whereas first-line therapy used for secondary ITP is usually similar to the one commonly used in primary ITP and relies mostly on corticosteroids +/- intravenous immunoglobulin according to the severity of bleeding, second and third-line treatments must take into account the type and degree of activity of the underlying disease. (C) 2020 Societe Nationale Francaise de Medecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.

Automated summary

Secondary ITP, accounting for 20% of cases in adults, is often caused by B-cell lymphomas, chronic lymphocytic leukemia, systemic autoimmune diseases, and common variable immunodeficiency. Treatment for secondary ITP is similar to that for primary ITP, but consideration of underlying disease type and activity is crucial for second and third-line treatments.