Statement of Principles concerning idiopathic thrombocytopaenic purpura No. 19 of 1997 (Cth)

Instrument No.19 of 1997

Determination

of

Statement of Principles

concerning

IDIOPATHIC THROMBOCYTOPAENIC PURPURA

ICD CODE: 287.3

Veterans’ Entitlements Act 1986

1. This Statement of Principles is determined by the Repatriation Medical Authority under subsection 196B(2) of the Veterans’ Entitlements Act 1986 (the Act).

Kind of injury, disease or death

1. (a) This Statement of Principles is about idiopathic thrombocytopaenic purpura and death from idiopathic thrombocytopaenic purpura.

(b) For the purposes of this Statement of Principles, “idiopathic thrombocytopaenic purpura” means an acquired low platelet count on repeated testing, which results from excessive platelet destruction mediated by immune mechanisms in the absence of a known cause of thrombocytopaenia and which requires treatment such as steroids, platelet infusion or splenectomy, attracting ICD code 287.3.  Known causes of thrombocytopaenia include systemic infections, systemic diseases, drugs and chemical exposures.  The bone marrow in idiopathic thrombocytopaenic purpura is essentially normal, and platelet-associated antibodies are demonstrable in the majority of patients.  The disease is seen in acute and chronic forms, the acute form usually affecting children and the chronic form affecting adults.  When the count is sufficiently low abnormal bleeding manifestations such as purpura occur.

Basis for determining the factors

1. The Repatriation Medical Authority is of the view that there is sound medical-scientific evidence that indicates that idiopathic thrombocytopaenic purpura and death from idiopathic thrombocytopaenic purpura can be related to relevant service rendered by veterans, members of Peacekeeping Forces, or members of the Forces.

Factors that must be related to service

1. Subject to clause 6, the factor set out in the paragraph in clause 5 must be related to any relevant service rendered by the person.

Factors

1. The factor that must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting idiopathic thrombocytopaenic purpura or death from idiopathic thrombocytopaenic purpura with the circumstances of a person’s relevant service is:

(a)        inability to obtain appropriate clinical management for idiopathic thrombocytopaenic purpura.

Factors that apply only to material contribution or aggravation

1. Paragraph 5(a) applies only to material contribution to, or aggravation of, idiopathic thrombocytopaenic purpura where the person’s idiopathic thrombocytopaenic purpura was suffered or contracted before or during (but not arising out of) the person’s relevant service; paragraph 8(1)(e), 9(1)(e), 70(5)(d) or 70(5A)(d) of the Act refers.

Other definitions

1. For the purposes of this Statement of Principles:

“ICD code” means a number assigned to a particular kind of injury or disease in the Australian Version of The International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM), effective date of 1 July 1996, copyrighted by the National Coding Centre, Faculty of Health Sciences, University of Sydney, NSW, and having ISBN 0 642 24447 2;

“relevant service” means:

(a)       operational service; or

(b)       peacekeeping service; or

(c)       hazardous service.

Dated this       Twentieth          day of              February           1997

The Common Seal of the    )

Repatriation Medical Authority                   )

was affixed to this instrument   )

in the presence of   )

KEN DONALD

CHAIRMAN