Pavol Hollý, Ján Staško, Peter Kubisz
Immune thrombocytopenic purpura, an autoimmune disorder with autoantibodies against the surface platelet epitopes, isolated thrombocytopenia and hemorrhagic diathesis, is a rather common cause of thrombocytopenia. An acute and chronic form is distinguished. Several strategies (usually immunosuppressive and immunomodulatory therapy, splenectomy) are used in its treatment, focused on the elimination of bleeding risk and the cause of thrombocytopenia. In spite of adequate therapy, a considerable number of patients (cca 20 - 30 %) have a long-lasting severe thrombocytopenia (refractory ITP), associated with higher morbidity and mortality. Thrombopoietin mimetics and rituximab belong to the new therapeutic options, preferably used within this patient group. There is a growing clinical experience with the use of recombinant activated factor VII (rFVIIa) in the treatment of acute bleeding.