Which of the following is generally not seen in idiopathic thrombocytopenic purpura (ITP)?

Discussing options one by one: a. Chronic ITP occurs most commonly in adult women, younger than age 40 years (Female: Male = 4:1) b. Cutaneous bleeding occurs in the form of pinpoint hemorrhages, petechiae or ecchymoses. Often there will be history of easy bruising, nose bleeds, bleeding from gums and hemorrhage in soft tissues from relatively minor trauma. c. Despite the increased destruction of platelets in spleen, spleen size usually remains normal in ITP. d. Bone marrow reveals a modestly increased number of megakaryocytes.