Selective Mediterranean Diet in Immune Thrombocytopenia

This randomized controlled trial aims to evaluate the effect of a selective Mediterranean diet regimen, used as an adjunct to standard therapy, on platelet count and bleeding-related outcomes in adult patients with primary immune thrombocytopenia (ITP).

Inclusion Criteria: * Age 18-60 years * Diagnosis of primary immune thrombocytopenia according to American Society of Hematology (ASH) criteria * Platelet count \< 100 × 10⁹/L at enrollment * Willingness to comply with the dietary protocol and follow-up schedule Exclusion Criteria: * Secondary thrombocytopenia * Pregnancy or lactation * Uncontrolled diabetes mellitus, chronic kidney disease, or hepatic failure * Strict dietary regimens for other medical conditions * History of bariatric surgery or malabsorption syndromes * Known food allergies to core Mediterranean diet components * Active chemotherapy or splenectomy within the last 3 months * Prednisone/prednisolone ≥ 20 mg/day (or equivalent) at enrollment or recent dose adjustment within 2 weeks * Poor compliance or inability to attend follow-up visits