Usually presents with haemorrhagic manifestations, purpura, epistaxis, menorrhagia or bleeding gums but may occasionally be detected in an asymptomatic adult patient on a routine blood test. Intracranial bleeds occur in <1% (associated with platelet count <10 x 109/L). Commonest in young adults (3>9). The natural history of childhood cases is acute in 90% and usually follows a self-limiting course without treatment. They are often associated with a history of previous viral illness and complete resolution may be expected within 3 months. In adults a chronic course is usual and spontaneous resolution is rare (<5%).

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