الفهرس 
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Abstract
Background : Immune thrombocytopenia is an acquired auto-reactive immune disease which is characterized mainly by a reduced platelet number beside an associated raised hazard of bleeding. Platelet degradation is due to the quick clearance of antibody-bound platelets by the reticuloendothelial system in the spleen and liver. Defective platelet production may be due to autoreactive antibody-promoted apoptosis. Although Auto-reactive T lymphocytes are responsible for platelet and MK break down. Eltrombopag is the 1st oral, non-peptide TPO-RA appropriate for the treatment of chronic ITP in patients with inadequate response to at least one other treatment. Eltrombopag is considered the best line of treatment of chronic ITP because it improves platelet synthesis by binding to the transmembrane domain of the thrombopoietin receptor. Aim of the work : The study aims to assess the effect of eltrombopag in treatment of chronic ITP 1-year duration in females with menorrhagia as an alternative line of treatment to splenectomy. Materials and Methods : A cross-sectional study was carried out over a period of 2 years between March 2018 till March 2020 including 20 adolescent females diagnosed as having chronic ITP manifested by menorrhagia, who were given eltrombopag as the third line of treatment with follow up of bleeding symptoms and platelet counts. Results: We found that all of our patients showed improvement of menorrhagia with the improvement of platelet counts without the need of adds on or rescue treatment. We although managed to stop the treatment successfully in four of them. Conclusion: Our study confirmed that eltrombopag is a successful agent in the management of chronic ITP. Eltrombopag enhances the platelet response effectively, decreases the risk of major bleeding or any bleeding events, and reduces the percentage of patients needing rescue therapy. The oral use of eltrombopag with the high response rates and safety make it a preferable line of treatment than splenectomy.