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What is ITP? -

ITP is an autoimmune disorder caused by a decrease in the number of platelets in the blood. This consequently doesn’t allow the blood to clot as quickly as it normally would.

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How does it manifest? -

ITP is caused by an immune reaction against a person’s own platelets. A low platelet count can result in bruising and bleeding, both internally and externally.

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Name change -

Originally called idiopathic thrombocytopenic purpura, ITP now stands for immune thrombocytopenia. The reason for the name change is that the condition is no longer considered "idiopathic" (i.e. cause unknown) and because "purpura," which refers to the discoloration of the skin, is not always a symptom.

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Type of condition -

ITP is an autoimmune disease, but it's not hereditary, nor is it contagious. ITP can be classified as both primary (occurring on its own) and secondary (triggered by another condition).

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Acute ITP -

There are two main types of ITP, the first one being the acute (and most common) version of the condition. Acute ITP usually lasts less than six months, and it normally affects children (mostly between ages two to six).

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Chronic ITP -

And then we have the chronic version of the condition, which can last six months or longer. It’s more common among adults (though teenagers are also at risk).

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Causes -

Platelets help blood coagulate, which is how our bodies stop bleeding and we heal from wounds and cuts.

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Causes -

But the immune system’s antibodies for people with ITP attack their own platelets. There are many things that can trigger this reaction.

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Causes -

Possible triggers include other autoimmune diseases, chronic inflammation, viral infections, some medications, pregnancy, dehydration, and some types of cancer.

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Symptoms -

Easy, unexplained bruising is one of the most common symptoms. Red-purple dots that look like a skin rash, called petechiae, are another one.

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Symptoms -

Other symptoms include gum bleeding, nosebleeds, cuts taking a long time to heal, blood in urine and/or stools, and unusually heavy periods.

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Diagnosis -

Diagnosis is usually done after a thorough physical exam, as well as blood work. Blood tests may include a complete blood count (CBC) and look at electrolyte levels, liver and kidney function, and platelet antibodies.

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Treatment -

Treatment will depend on a number of factors, namely the total number of platelets and how often, and how much, the patient bleeds.

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Treatment -

Typically those who are affected by acute ITP (mostly children) do not require any type of treatment, and symptoms usually subside in less than six months.

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Lifestyle changes -

Lifestyle changes may be an important factor when it comes to treating ITP. This includes a review of any medication a person is taking, and avoiding drugs that can affect platelet function.

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Lifestyle changes -

Other changes include limiting alcohol consumption (which can affect blood clotting), and choosing low impact physical activity that reduces the risk of bruising (as opposed to some sports where the risk is higher).

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Corticosteroids -

Though in other cases, sometimes medication is needed. This includes steroids. Corticosteroids can be prescribed to decrease the immune response and increase platelet count.

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Intravenous immunoglobulin (IVIg) -

If bleeding gets too serious, then intravenous immunoglobulin (IVIg) may be required. This is a common treatment for people with weakened immune systems.

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Rho(D) immune globulin -

Patients who have Rh-positive blood may be able to to receive a treatment consisting of Rho(D) immune globulin.

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Rituximab -

Rituximab, also known under the brand name Rituxan, is an antibody medication that can also be used to treat ITP.

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Thrombopoietin receptor agonists -

These drugs stimulate the bone marrow to produce more platelets, which in turn helps prevent further bruising and bleeding.

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General immunosuppressants -

These are usually prescribed for severe cases of ITP that do not respond to other types of treatment. Because these drugs inhibit immune activity as a whole, they can have severe side effects.

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Antibiotics -

The bacteria Helicobacter pylori has been associated with ITP in some cases, so antibiotics may be a viable course of treatment for some people.

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Surgery -

If all medications fail, then a splenectomy may be required to remove the spleen. The spleen is a small organ just above the stomach, which is part of the lymphatic system (it filters blood and produces white blood cells to fight off infections).

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Platelet transfusion -

Those with severe bleeding may require a platelet transfusion as well.

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Possible complications -

Excessive bleeding can indeed lead to other problems, but complications can also occur due to the treatments. For example, removing the spleen can increase the risk of bacterial infections.

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Possible complications -

Long-term use of corticosteroids can also trigger a number of side effects, including osteoporosis, cataracts, and diabetes.

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Outlook -

Acute ITP is generally non-life-threatening and is not deemed very serious. Though it mostly affects children, as mentioned, it usually resolves itself in less than six months.

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Outlook -

Those with chronic ITP, however, do need to be followed by a doctor and must manage their condition.

Sources: (Healthline) (John Hopkins Medicine) (National Today)

See also: Bloodwork—the history of hemophilia

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