Immune Thrombocytopenic Purpura (ITP) Bleeding Scale (IBLS) of Page et al

Description

Page et al developed the Immune Thrombocytopenic Purpura Bleeding Scale (IBLS) to evaluate patients with ITP. The IBLS can be used to monitor bleeding and the response to therapy. The authors are from Weill Medical College of Cornell University, GlaxoSmithKline, the Feinstein Institute for Medical Research and LIJ Health Systems.

Patient selection: ITP

Outcome: bleeding manifestations (with Grade 2 more serious than Grade 1)

Parameters:

(1) skin on physical examination

(2) skin by history

(3) oral on physical exam

(4) oral by history

(5) epistaxis

(6) gastrointestinal tract

(7) urinary tract

(8) gynecological tract

(9) pulmonary

(10) intracranial hemorrhage

(11) subconjunctival hemorrhage

Parameter	Finding	Points
skin by exam	none	0
	1-5 bruises OR scattered petechiae	1
	> 5 bruises with size > 2 cm OR diffuse petechiae	2
skin by history	none	0
	1-5 bruises OR scattered petechiae	1
	> 5 bruises with size > 2 cm OR diffuse petechiae	2
oral by exam	none OR <= 5 petechiae	0
	1 blood blister OR > 5 petechiae OR gum bleeding that clears easily with rinsing	1
	multiple blood blisters OR gum bleeding	2
oral by history	none OR <= 5 petechiae	0
	1 blood blister OR > 5 petechiae OR gum bleeding <= 5 minutes	1
	multiple blood blisters OR gum bleeding > 5 minutes	2
epistaxis	none	0
	when blowing nose OR <= 5 minutes per episode	1
	> 5 minutes per episode	2
gastrointestinal tract	none	0
	occult blood	1
	macroscopic, gross	2
urinary tract	none	0
	microscopic or by dipstick	1
	macroscopic	2
gynecological tract	none	0
	spotting not at the time of normal period	1
	bleeding more than spotting not at time of period OR very heavy period	2
pulmonary	no	0
	yes	2
intracranial hemorrhage	no	0
	yes	2
subconjunctival hemorrhage	no	0
	yes	1

Interpretiation:

• The number of sites at each grade of bleeding are tallied.

• With effective therapy Grades 1 and 2 should be replaced by Grade 0.

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Immune Thrombocytopenic Purpura (ITP) Bleeding Scale (IBLS) of Page et al

Description

Specialty