Just the facts: approach to adult patients with immune thrombocytopenic purpura in the emergency department

Clinical scenarioA 32-year-old woman presents to the emergency department (ED) with a 2-day history of petechial rash on her legs and easy bruising.She denies trauma, recent illness, or medication use.Her vital signs are stable.On examination, she has no active bleeding, but scattered petechiae are noted on her lower limbs with wet purpura along the mucosal surface of the right cheek.