Overview
Idiopathic thrombocytopenic purpura (ITP) is an illness characterized by low levels of platelets in the blood, leading to increased susceptibility to bruising and bleeding. It was previously known as immune thrombocytopenia. The condition may present with purple bruises and tiny reddish-purple dots on the skin, resembling a rash. ITP can be caused by a viral infection in children, while adults often experience long-lasting symptoms. Treatment options may include medications to increase platelet count or surgery to remove the spleen, depending on the severity of symptoms.
Understanding the disease
Symptoms
Symptoms of immune thrombocytopenia (ITP), which was previously known as idiopathic thrombocytopenic purpura, may include:
- Easy bruising
- Bleeding into the skin that looks like tiny reddish-purple spots (petechiae)
- Bleeding into the skin that's larger than petechiae (purpura)
- Bleeding from the gums or nose
- Blood in urine or stools
- Heavy menstrual flow ITP is typically caused by the immune system mistakenly attacking and destroying platelets. If you or your child experience any of these symptoms, it's important to consult a healthcare provider for further evaluation and guidance.
Development
Immune thrombocytopenia (ITP) develops when the immune system mistakenly attacks and destroys the cells that help blood clot, known as platelets. This illness can lead to bruising and bleeding. In adults, ITP can be caused by an infection with HIV, hepatitis, or H. pylori, while in children, it often follows a virus such as the mumps or the flu. ITP might not have symptoms, but when present, they can include easy bruising, bleeding into the skin that resembles petechiae or purpura, bleeding from the gums or nose, and blood in urine or stools. ITP is more common among young women and those with other diseases that involve the immune system attacking healthy tissues, such as rheumatoid arthritis or lupus.
Assessment and Diagnosis
Triage
You should see a doctor if you or your child has symptoms that worry you, such as easy bruising, bleeding into the skin that looks like tiny reddish-purple spots (petechiae), bleeding that's larger than petechiae (purpura), bleeding from the gums or nose, blood in urine or stools, or really heavy menstrual flow. Bleeding that won't stop is a medical emergency, and you should seek help right away if you or your child has bleeding that the usual first aid efforts can't control.
Diagnosis
To diagnose immune thrombocytopenia (ITP), a health care provider will try to rule out other possible causes of bleeding and a low platelet count. There is no single test to confirm the diagnosis. Blood tests can check platelet levels, and sometimes adults might need a bone marrow biopsy to rule out other problems. Treatment may include medicines to increase platelet count or surgery to remove the spleen. Some people with mild ITP might not require treatment, while most adults will need treatment at some point.
Management and Treatment
Complications
Potential complications of immune thrombocytopenia (ITP) include rare cases of bleeding into the brain, which can be fatal. In pregnant individuals with low platelet counts or those experiencing bleeding, there is a higher risk of heavy bleeding during delivery. Other possible complications include anemia, a decrease in red blood cells and hemoglobin, and thrombocytopenia, a low count of platelets involved in clotting. Less common complications may involve the nervous system, such as meningitis, encephalitis, or Guillain-Barre syndrome. Additionally, there could be heart problems like myocarditis, an inflammation of the heart muscle, or swollen tonsils that can block breathing.
Home Remedies
It is important to consult a healthcare provider for proper diagnosis and treatment recommendations for idiopathic thrombocytopenic purpura (ITP).
Treatment
Treatments for idiopathic thrombocytopenic purpura (ITP) may include:
- Watchful waiting: If the platelet count is not too low and bleeding is not severe, doctors may choose to monitor the situation closely without immediate treatment.
- Medication: Medications that can raise platelet count include corticosteroids such as prednisone, immunoglobulin injections, and medications that target the immune system, like rituximab.
- Splenectomy: In some cases, surgical removal of the spleen (splenectomy) may be recommended if other treatments have not been effective in raising platelet counts or if the spleen is causing significant enlargement or discomfort.
- Blood transfusions: In cases of severe bleeding or when platelet counts are very low, blood transfusions may be given to temporarily increase platelet levels.
- Lifestyle changes: Depending on the individual's specific situation, doctors may recommend avoiding certain medications or supplements that can lower platelet counts, such as aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs). It's important to note that treatment approaches for ITP may vary based on factors such as age, overall health, severity of symptoms, and the individual's response to previous treatments. Consultation with a healthcare professional is necessary to determine the most appropriate treatment plan.
Preparing for medical consultation
To prepare for an appointment for idiopathic thrombocytopenic purpura (ITP), you should follow the general steps for preparing for any medical appointment. Here are the steps tailored to ITP:
- Make a list of your symptoms: Note when they began, how often they occur, and any triggers or worsening factors. Include any unrelated symptoms as well.
- Gather your medical history: Prepare a list of any previous medical conditions, surgeries, or procedures you've undergone. Also, include any current medications, vitamins, or supplements you're taking.
- Research ITP: Familiarize yourself with the symptoms, causes, and treatment options for ITP. This can help you ask informed questions and contribute to your appointment.
- Write down key personal information: Include any recent life changes, stressors, or illnesses that could be related to your ITP. Additionally, mention any family medical history relevant to blood disorders.
- Prepare questions to ask your provider: Some basic questions to ask your provider include:
- What is the most likely cause of my ITP?
- Are there any other possible causes for my symptoms?
- Do I need any tests to confirm the diagnosis?
- What treatments are available for ITP?
- Are there any lifestyle changes or dietary restrictions I should follow?
- What is the expected course and prognosis for my condition? Remember to bring any relevant medical records or test results to your appointment. Being well-prepared can help you make the most of your time with your healthcare provider and ensure that your concerns are addressed.