Adult idiopathic thrombocytopenic purpura(ITP)is achronic acquired organ-specific autoimmunehemorrhagic disease characterized by the production ofauto-antibodies against antigens on the membranes ofplatelet,resulting in enhanced Fc-mediated destruction ofthe platelets by macrophages in the reticuloendothelialsystem.Splenectomy remains the best treatment ofchronic ITP,but approximately 30% of patients do notrespond or relapse after surgery;these patients aredefined as patients with chronic refractory ITR There is Adult idiopathic thrombocytopenic purpura (ITP) is achronic acquired organ-specific autoimmune hemorrhagic disease characterized by the production ofauto-antibodies against antigens on the membranes of platelet, resulting in enhanced Fc-mediated destruction of the platelets by macrophages in the reticuloendothelial system .plectomy remains the best treatment of chronic ITP, but approximately 30% of patients do notrespond or relapse after surgery; these patients aredefined as patients with chronic refractory ITR There is