Perioperative Management of the Patient with Immune Thrombocytopenic Purpura De Novo and the Thrombocytopenia of Antiphospholipid Antibody Syndrome

Immune thrombocytopenic purpura (ITP) was first recognized in the fifteenth century by the physician Avicenna [1]. Thrombocytopenia was further elaborated on in the 1600s, and the association between thrombocytopenia and purpura was drawn by Krauss [1]. Harrington proved that ITP was due to an element in the plasma (likely an antibody) by transfusing plasma from patients with ITP into healthy individuals; the result was thrombocytopenia in the recipient group [2].ITP is a relatively common disease occurring with a frequency of 5.8 cases/100,000 in children and 4.6/100,000 in adults [3–5]. The disease is more frequent in women (4.4 affected per 100,000 patient years, 95% CI 4.1–4.7) than in men (3.4 affected per 100,000 patient years, 95% CI 3.1–3.7) [6]. ITP is much more common in patient with rheumatological diseases; for example, up to 25% of patients with systemic lupus erythematosus will develop thrombocytopenia during the course of their illness [7].