ITP disease (immune thrombocytopenic purpura) is a bleeding disorder in which the immune system destroys platelets necessary for normal blood clotting. People with the disease have very few platelets in their blood. You can find more information below.
What is an ITP fault?
ITP disease, also known as immune thrombocytopenia , is a bleeding disorder. In ITP, the blood does not clot as it should. This is due to a small number of blood cell fragments called platelets or platelets.
Platelets are made in your bone marrow along with other blood cells. They stick together (clot) to seal small cuts or breaks in blood vessel walls and stop bleeding. Without enough platelets, bleeding can occur inside the body (internal bleeding), under the skin, or in the skin (external bleeding).
People with ITP disease often have areas of purple skin called purpura . These areas appear on the skin or mucous membranes (for example, in the mouth). Bleeding from small blood vessels under the skin causes purpura.
People with ITP may also have bleeding that causes small red or purple spots on the skin. These points are called petechiae . Petechiae may look like a rash.
People with ITP may have nosebleeds, bleeding from the gums during dental treatment, or other conditions where the bleeding is difficult to stop. Women with ITP may also have heavier-than-normal menstrual bleeding.
Too much bleeding can cause hematomas. A hematoma is a collection of coagulated or partially coagulated blood under the skin. They look or feel like a lump.
Bleeding in the brain as a result of ITP disease is very rare, but can be life-threatening if it does occur. ITP disease is not transmitted from one person to another.
Types of ITP disease
There are two types of ITP, one is acute (temporary or short-term) and the other is chronic (long-lasting).
Acute ITP usually lasts less than 6 months. It occurs mainly in both boys and girls and is the most common type of ITP. Acute ITP usually occurs after a viral infection.
Chronic ITP lasts 6 months or longer and mostly affects adults. However, some teenagers and children can get this type of ITP. Chronic ITP affects women two to three times more often than men.
Treatment depends on the severity of the bleeding and the platelet count. Mild cases may not need treatment.
Outlook in ITP disease
For most children and adults, ITP is not a serious or life-threatening condition.
Acute ITP in children usually goes away on its own within a few weeks or months and does not return. In 80 percent of children with ITP, the platelet count returns to normal within 6 to 12 months. Treatment may not be needed.
For a small number of children, ITP does not go away on its own and may require further medical or surgical treatment.
Chronic ITP varies from person to person and can last for years. Even people with severe chronic forms of ITP can live for decades. Most people with chronic ITP can stop treatment at some point and maintain a safe platelet count.
What causes ITP disease?
In most cases, an autoimmune response is thought to cause immune thrombocytopenia (ITP). Normally, your immune system helps your body fight infections and diseases. But in ITP, your immune system mistakenly attacks and destroys your body’s platelets. It is not yet known why this happens.
In some people, ITP can be linked to viral or bacterial infections such as HIV, hepatitis C, or H. pylori.
Children with acute (short-term) ITP often have had recent viral infections. These infections can trigger or affect the immune reaction that leads to ITP.
Who is at risk?
Immune thrombocytopenia (ITP) is a very common blood disorder. Both children and adults can develop ITP.
Children usually have the acute (short-term) type of ITP. Acute ITP usually develops after a viral infection.
Adults tend to have the chronic (long-term) type of ITP. Women are two to three times more likely than men to develop chronic ITP.
The number of ITP cases is increasing because routine blood tests that can detect low platelet counts are more frequent.
What are the symptoms of ITP disease?
Immune thrombocytopenia (ITP) may not cause any signs or symptoms. However, ITP can cause bleeding inside the body or bleeding under the skin or in the skin. Bleeding symptoms may include:
- Bruising or purplish areas on the skin or mucous membranes (such as in the mouth). These areas are called purpura. They are caused by bleeding under the skin and can occur for any reason.
- Red patches on the skin, called patechia, are often found in groups and may look like a rash. Bleeding under the skin causes petechiae.
- There may be a collection of clotted or partially clotted blood that looks or feels like a lump under the skin, this is called a hematoma.
- There may be nosebleeds or excessive bleeding from the gums (for example, during dental work).
- There may be blood in the urine or stool.
Any bleeding that is hard to stop can be a sign of ITP disease. This includes heavier-than-normal menstrual bleeding. Bleeding in the brain is rare and its symptoms can vary.
A low platelet count does not directly cause pain, concentration problems, or other symptoms. However, a low platelet count may be associated with fatigue .
How is ITP disease diagnosed?
Your doctor will diagnose immune thrombocytopenia (ITP) based on your medical history, physical exam, and test results.
Your doctor will want to make sure that your low platelet count isn’t caused by another condition (such as an infection) or medications you’re taking (such as chemotherapy drugs or aspirin ).
Your doctor may ask:
- Bleeding and other symptoms you experience
- Diseases that may lower your platelet count or cause bleeding
- If you are taking supplements, prescription or over-the-counter medications that can cause bleeding or lower your platelet count
During the physical exam, your doctor will look for bleeding and signs of infection. For example, your doctor may look for purplish areas of the skin or mucous membranes and detect red patches on the skin. These are signs of bleeding under the skin.
You will likely have a blood test to check your platelet count. These tests usually include:
- A complete blood count : This test checks the number of red blood cells, white blood cells, and platelets in your blood. In ITP, the red and white blood cell counts are normal, but the platelet count is low.
- Blood smear test : For this test, some of your blood is put on a slide. A microscope is used to look at your platelets and other blood cells.
You may also have a blood test to check for antibodies (proteins) that attack platelets. If blood tests show you have a low platelet count, your doctor may recommend further testing to confirm the diagnosis of ITP. For example, bone marrow tests can show whether your bone marrow is making enough platelets.
If you’re at risk for HIV, hepatitis C, or H. pylori, your doctor may screen you for these infections that may be linked to ITP disease.
Some people with mild ITP have little or no signs of bleeding. They can only be diagnosed if a blood test for another reason shows they have low platelet counts.
How is ITP disease treated?
Treatment for immune thrombocytopenia (ITP disease) depends on how much and how often you bleed and your platelet count.
Adults with mild ITP may not need any treatment other than monitoring their symptoms and platelet counts. Adults with very low platelet counts or bleeding problems are often treated.
The acute (short-term) type of ITP that occurs in children usually goes away within a few weeks or months. Children with signs of bleeding other than just bruising (purpura) are usually treated.
Children with mild ITP may not need treatment other than monitoring and follow-up to make sure their platelet counts return to normal.
Medications are often used as the first line of treatment for both children and adults.
Corticosteroids such as prednisone are commonly used to treat ITP. These drugs, called steroids for short , help increase your platelet count. However, steroids have many side effects, and in some people, the disease may relapse when treatment ends.
The steroids used to treat ITP are different from the illegal steroids some athletes take to improve performance. Corticosteroids are not habit-forming, even if you take them for years.
Other drugs are also used to increase the platelet count. Some are given with a needle inserted into a vein. These drugs include rituximab, immune globulin, and anti-Rh(D) immunoglobulin.
Remember, your doctor will decide which medicine to take and how.
Removal of the spleen (splenectomy)
If necessary, doctors can surgically remove the spleen.
This organ is located in the left upper abdomen. The spleen is about the size of a golf ball in children and a baseball in adults. The spleen makes antibodies (proteins) that help fight infections. In ITP, these antibodies mistakenly destroy platelets.
If ITP has not responded to medications, removal of the spleen will reduce the destruction of platelets. However, it can also increase your risk of infection. Before surgery, your doctor may give vaccines to help prevent infections.
If your spleen is removed, your doctor will explain what steps you can take to avoid infections and what symptoms to watch for.
- Platelet transfusions
Some people with ITP who have severe bleeding may need a platelet transfusion and hospitalization. Some people will need a platelet transfusion before surgery.
For platelet transfusion, donor platelets from a blood bank are injected into the recipient’s bloodstream. This increases the platelet count for a short time.
- Treatment of infections
Some infections can briefly lower your platelet count. Treating the infection can help increase your platelet count and reduce bleeding problems.
- stopping medications
Some medications can lower your platelet count or cause bleeding. Stopping the medication can sometimes help raise your platelet count or prevent bleeding.
For example, aspirin and ibuprofen are common drugs that increase the risk of bleeding. If you have ITP, your doctor may recommend that you avoid these medications.
Your doctor will decide which treatment will be best for you.
Living with ITP disease
If you have immune thrombocytopenia (ITP disease), you can take steps to prevent complications. Lifestyle changes and ongoing care can help you manage the condition.
Try to avoid injuries that can cause bleeding in the brain, especially head injuries. For example, do not participate in contact sports such as boxing, football or karate. Other sports, such as skiing or horseback riding, also put you at risk for injury that can cause bleeding.
Some safe activities are swimming, cycling (with helmet), and walking. Ask your doctor about physical activities that are safe for you.
Take precautions such as regular use of seat belts and gloves when handling knives and other tools.
If your child has ITP, ask their doctor if you should restrict your child’s activities.
You may want to find a doctor familiar with treating people who have ITP. For example, hematologists are doctors who specialize in the diagnosis and treatment of blood disorders. You should be able to talk to your doctor about how to manage ITP and when to seek medical attention.
Talk to your doctor before taking any prescription or over-the-counter medicines, supplements, vitamins, and herbal remedies. Some medications and supplements can affect platelets and increase your risk of bleeding. Common examples are aspirin or ibuprofen. Your doctor may recommend that you avoid these drugs.
Watch for signs of infection such as fever and report them to your doctor immediately. If your spleen has been removed, you may be more likely to get sick from certain infections.
ITP disease in pregnancy
In women who are pregnant and have ITP, the disease usually does not affect the baby. However, some babies may develop low platelet counts shortly after birth.
Babies’ platelet count almost always returns to normal without any treatment. In infants with very low platelet counts, treatment can speed recovery.
Treatment for immune thrombocytopenia (ITP) in pregnancy depends on the woman’s platelet count. If treatment is needed, the doctor will look closely at the possible effects of the treatment on the unborn baby.
Women with mild cases of ITP are usually able to sustain a pregnancy without treatment. Pregnant women with a very low platelet count or bleeding a lot are more likely to bleed heavily during or after childbirth. To prevent heavy bleeding, these women are usually treated.
Finally , you may want to read our article titled TTP disease , which is a similar disease.