Idiopathic thrombocytopenic purpura or also known as immune thrombocytopenia (ITP) is an immune disorder resulting in unusually low levels of platelets.
Platelets are the cells responsible for helping blood to clot. So if your platelets are low, your blood is most likely slow to clot. Patients who happen to have ITP experience excessive bruising or bleeding.
The said condition could also result in both external or internal bleeding. There are also patients who happen to have purple bruises which are called purpura on the skin. For some cases, patients who have ITP develops mucous membranes inside the mouth or red and purple dots on the skin called petechiae. These dots may look similar to a rash.
Regardless of age, children and adults may develop ITP. Children who experience ITP after infection would recover even without treatments. However, older people who have the condition could experience ITP for a longer period of time.
There are also specific illnesses that are linked to ITP such as mumps, measles, and chickenpox.
Causes of ITP
The term “idiopathic” means “unknown cause”. Having said, the causes of ITP are still not known.
However, experts were able to identify that a weak immune system has something to do with the development of ITP. This is because the immune system mistakenly starts to attack and destroy the platelets.
This is because, for people who have ITP, the immune system produces antibodies which then marks the platelets target for destruction.
Your body also has the ability to protect itself from any illness or virus. However, the spleen that is responsible in doing such work mistakenly gets rid of the platelets which have antibodies. This mistaken identity then leads to a decreased number of platelets.
Normally, your platelet should range from 150,000 to 450,000 per microliter of blood circulating in your body. For people who have ITP, their platelet count would be below 20,000. This then results in bleeding since as the platelet count drops, the possibility of bleeding also increases. Cases of ITP for people who have platelet count below 10,000 would be risky already.
Types of ITP
Similar to other illnesses, ITP also has two kinds; acute (short-term) and chronic (long-term).
Acute ITP cases usually happen in children. This type of ITP only lasts for 6 months and would even go away even without treatment.
On the other hand, chronic cases of ITP are most common in adults. This condition would go beyond 6 months. Even though common to adults, chronic ITP may also happen on teenagers and children.
Symptoms of ITP
Some patients do not develop any symptoms of ITP. Furthermore, below is a list of the most common symptoms of ITP.
- Blood in the stool
- Blood in urine
- Bleeding from cuts
- Bleeding during surgery
- Random nosebleeds
- Bleeding in gums
- Petechiae in the lower legs
- Abnormal heavy menstruation
Risk Factors and Complications
Anyone could be vulnerable to experiencing ITP. However, there are certain cases which could increase risks or triggers to developing ITP.
- Gender – Your sex also has something to do with your chances of having ITP. Unlike men, women are more vulnerable to ITP. It is even identified that women’s chances of catching ITP are 2 to 3% higher than of men.
- Viral Infection – According to studies, children who had recent viral infections are most likely to develop ITP after recovery.
Complications in ITP
Pregnant women who have ITP are also prone to excessive bleeding. However, ITP may not be able to affect the baby directly. Regardless of the situation, experts would still recommend the mother to have the platelets of the baby counted after giving birth.
Cases of ITP in pregnant women would need regular monitoring. Most especially if the platelet count of the mother is really low. Doctors would also require the mother to have her platelet count regularly as well as blood testing.
It would take a series of tests in order for ITP to be diagnosed. Aside from checking of the patient’s medical history, doctors would also require other tests such as blood testing for platelet count. Your doctor would also use your blood sample to check for other possible complications such as your kidney and liver function.
It is also possible for your doctor to request a bone marrow test. This is because the status of your bone marrow may also be your doctor’s basis to check if you have ITP or none. Once your bone marrow is normal, your low platelet count could be due to ITP. This is because your platelets are destroyed upon leaving your bone marrow. On the contrary, the abnormal status of bone marrow would indicate that your low platelet count is due to a different illness or virus.
Treatments for ITP
As mentioned above, there are cases of ITP wherein the patient wouldn’t need any treatment.
The treatment that will be given to you will also depend on your platelet count as well as your bleeding pattern. With or without treatment, your doctor will still be requiring you to have your platelet and red blood cells checked from time to time.
One of the most common ways of treating ITP is through continuous medications. Doctors would usually prescribe drugs such as corticosteroids, rituximab, immunosuppressants, Thrombopoietin receptor agonists, antibiotics, and a lot more.
Splenectomy is the kind of surgery that will be advised for patients if their symptoms don’t improve from medications. If by chance your doctor would also recommend the removal of spleen if your symptoms don’t improve through medications.
For children who have ITP, splenectomy isn’t really advised since it could only risk the possibility of catching other bacterial infections.
Aside from medications and surgical procedures, your doctor may also advise you to reset your lifestyle.
As advised always, maintaining a healthy lifestyle could protect you from catching any kind of illness or disease.
For patients who have ITP, avoiding alcoholic drinks as well as over-the-counter drugs that could decrease platelet count may also be prohibited.