Immune thrombocytopenia (ITP) is an acquired autoimmune disorder characterized by increased platelet destruction and reduced platelet production. In adults, the disease course and treatment response vary widely. Real-world single-center data provide valuable insights into management. Therefore, sharing single-center experiences provides valuable insight into real-world data. The present study aimed to evaluate the demographic, clinical, and laboratory characteristics, as well as the treatment approaches and response outcomes of adult ITP patients managed at our hospital.

This retrospective study included 25 adult ITP patients followed at Düzce Atatürk State Hospital between October 2024 and August 2025. Data on demographics, laboratory findings, treatments, and responses were collected from patient records. Analyses were performed with SPSS version 25.0., Türkiye

The mean age of the patients was 57.5 ± 15.6 years, and 80% were female. The median platelet count at diagnosis was 11,000/mm³ (IQR 13,000). Whereas 76% of patients had no bleeding symptoms, 24% presented with ecchymosis and mucosal bleeding.

First-line treatment consisted mainly of corticosteroids (prednisolone in 96% and dexamethasone in 4%). Response rates were 36% complete, 36% partial, and 28% no response. IVIG was administered to 52% of patients, with 61.6% achieving a response and 38.4% showing no response.

In second-line therapy, 48% of patients received rituximab, with complete response observed in 67%, partial response in 25%, and no response in 8%. Eltrombopag was used in 25% of patients, yielding complete or partial responses in 80% and no response in 20%. Romiplostim was given to one patient (4%) with partial response.

Two patients (8%) underwent splenectomy, and both responded favorably. Reported complications included H. pyloriinfection (4%), ischemic stroke with colon carcinoma (4%), tick bite (4%), pulmonary embolism (4%), and portal vein thrombosis (4%). No complications were observed in 80% of patients.

Discussion/Conclusion:This study highlights the heterogeneity of clinical features and treatment outcomes in adult ITP. Corticosteroids provided responses in most patients, though nearly one-third remained refractory. IVIG offered limited benefit. Rituximab and eltrombopag produced favorable results, while romiplostim was less used. Both splenectomized patients responded well, supporting its role as a durable option despite declining frequency.Complications were uncommon but clinically significant, stressing the need for close monitoring. In conclusion, first-line therapies often show limited effectiveness, requiring second-line strategies. Rituximab and TPO receptor agonists were moderately effective, and splenectomy remains a valid option. These findings emphasize the importance of individualized treatment in adult ITP management.