Idiopathic Thrombocytopenic Purpura

Immune thrombocytopenia (ITP) is a condition that can cause easy bruising and bleeding. This happens because the body's immune system mistakenly attacks and destroys platelets, the tiny particles in your blood that help stop bleeding. Previously called idiopathic thrombocytopenic purpura, this condition can be easily recognized by the characteristic symptoms.

ITP can lead to purplish bruises (purpura) on the skin. You might also see tiny reddish-purple spots that look like a rash. These spots are a result of bleeding under the skin's surface.

Children often develop ITP after a viral infection. In many cases, the condition resolves on its own without any treatment. However, in adults, ITP can persist for months or even years.

If you have ITP but aren't experiencing significant bleeding and your platelet count isn't dangerously low, you might not need treatment. However, if you have more severe symptoms, such as heavy bleeding, treatment options can include medications designed to increase platelet production or, in some situations, surgery to remove the spleen. The goal of treatment is to manage the symptoms and prevent complications.

Immune thrombocytopenia (ITP) can sometimes cause no noticeable problems. However, if symptoms do appear, they might include:

• Easy bruising: This means you might bruise more easily than usual, even from minor bumps or knocks.

• Tiny red or purple spots on the skin (petechiae): These tiny spots look like a rash, often appearing on the lower legs. They're caused by tiny blood vessels leaking under the skin.

• Larger areas of bleeding under the skin (purpura): These are bigger than the tiny spots and can appear as reddish-purple patches or areas of discoloration.

• Nosebleeds or bleeding gums: These are signs that your blood isn't clotting properly.

• Blood in your urine or stool: This is a serious symptom requiring immediate medical attention.

• Heavy menstrual bleeding: Women with ITP might experience unusually heavy periods.

If you or your child are experiencing any of these symptoms, it's important to schedule an appointment with your doctor. Any bleeding that won't stop, no matter how small, is a medical emergency. Immediately seek help if you or your child are bleeding and standard first aid measures, such as applying pressure to the wound, aren't effective.

Immune thrombocytopenia (ITP) is a condition where the body's immune system mistakenly attacks and destroys platelets. Platelets are tiny blood cells crucial for helping blood clot when you get a cut or scrape. This mistaken attack leads to a low platelet count.

In grown-ups, ITP can sometimes be triggered by infections like HIV, hepatitis, or a bacterial infection called H. pylori (which can cause stomach ulcers). These infections can sometimes confuse the immune system, leading to the mistaken attack on platelets. In many cases, however, the cause isn't clear.

In children, ITP often develops after a viral infection, such as the mumps or flu. The virus might trigger a response in the immune system that mistakenly targets the platelets. Again, while a viral infection is often a preceding factor, the precise cause isn't always known.

Inflammatory bowel disease (IBD), specifically the type known as inflammatory bowel disease, is more often seen in young women. If you have IBD, your risk might be higher if you also have other conditions where your body's immune system mistakenly attacks healthy parts of your body. Examples of these conditions include rheumatoid arthritis and lupus. These conditions are sometimes grouped together as autoimmune diseases. Having an autoimmune disease along with IBD might increase the chances of developing IBD.

Immune thrombocytopenia (ITP) is a condition where the body's immune system mistakenly attacks its own platelets. Platelets are tiny parts of the blood that help stop bleeding. In rare cases, ITP can cause bleeding in the brain, which is very serious and can even be life-threatening.

If a pregnant person has ITP and a low platelet count, or if they are already bleeding, they have a higher chance of heavy bleeding during childbirth. To help manage this risk, a doctor might suggest treatments to increase and stabilize the platelet count.

Usually, ITP doesn't directly affect the developing baby. However, it's important to check the baby's platelet count soon after birth to make sure everything is okay. This is a routine precaution to ensure the baby's health.

Diagnosing immune thrombocytopenia (ITP) involves figuring out if something else is causing low platelet counts. There's no single test to confirm ITP. Doctors usually start by checking platelet levels through a blood test. This blood test is called a complete blood count (CBC). A complete blood count (CBC) measures different components of your blood, including platelets.

Sometimes, further testing is needed. This might include a bone marrow biopsy, which is a procedure to examine the bone marrow. A bone marrow biopsy is rarely needed in adults with suspected ITP. It's done to rule out other potential medical problems.

Mayo Clinic has a team of specialists who can provide care for people with ITP. They can help you understand and manage your condition. You can find more information and resources about ITP care at Mayo Clinic on their website.

Immune thrombocytopenia (ITP) is a condition where the body's immune system mistakenly attacks its own platelets, which are important for blood clotting. This can lead to easy bruising and bleeding.

How serious is it?

For some people, especially children, the low platelet count is mild and doesn't need treatment. Regular blood tests to monitor platelet levels might be enough. However, many adults with ITP will eventually need some kind of treatment. Sometimes the condition becomes more persistent or long-lasting, called chronic ITP.

Treating ITP:

Treatment options aim to increase platelet counts and reduce bleeding. A doctor will discuss the potential benefits and downsides of each approach with you. Sometimes, the side effects of treatment can be worse than the ITP itself.

Important Note: Tell your doctor about any medicines or supplements you take, even if they're not prescribed. Some things, like aspirin or ibuprofen, can increase bleeding and need to be stopped or adjusted. Ginkgo biloba is another example.

Common Treatment Approaches:

• Steroids: A common treatment is a type of steroid medicine, often taken by mouth (like prednisone). The dosage is gradually lowered once the platelet count improves to a safe level. However, long-term steroid use can increase the risk of infections, high blood sugar, and weak bones (osteoporosis).

• Immune Globulin: If steroids don't work, a medicine called immune globulin given as an injection might help. This can also be used for serious bleeding or to quickly increase platelet counts before surgery. The effects of this treatment usually last for a few weeks.

• Platelet-Boosting Drugs: Medicines like romiplostim, eltrombopag, and avatrombopag work by encouraging the bone marrow to produce more platelets. A possible side effect is an increased risk of blood clots.

• Other Drugs: Rituximab is a medicine that can reduce the immune system's attack on platelets. However, it can temporarily affect the effectiveness of vaccines. If a splenectomy (spleen removal) is needed later, the need for vaccinations to protect against illness may be higher. A newer medication, fostamatinib, is an option for people with chronic ITP who haven't responded to other treatments.

Splenectomy (Spleen Removal):

If medicines don't improve the condition, removing the spleen (splenectomy) might be an option. This surgery often stops the attacks on platelets and raises the platelet count. However, not everyone benefits, and removing the spleen increases the risk of infection.

Severe Bleeding:

In rare cases, ITP can cause severe bleeding. Emergency treatment often involves a blood transfusion to add more platelets. Steroids and immune globulin, given through a vein (intravenously), can also help.