Using a Western blot technique that allows quantitative detection of antibody reactivities to a large number of antigens, serum IgG and IgM antibody repertoires were compared in a group of 19 patients with a diagnosis of idiopathic thrombocytopenic purpura (ITP) and respective healthy controls. The results show that, irrespective of the duration of thrombocytopenia, age of the patients, and type of therapy, all ITP donors share characteristic alterations of serum antibody reactivity patterns on homologous erythrocyte and liver antigens. Multiparametric analyses of the immunoreactivity data readily segregated the groups of ITP and healthy donors. Similar analyses also distinguished ITP sera from those of a group of patients with systemic lupus erythematosus (SLE). We conclude that ITP is an autoimmune disease associated with generalized alterations of antibody repertoires, that may be characteristic enough to allow for diagnosis.