Idiopathic Thrombocytopenic Purpura (ITP)

What Is It?

ITP is an autoimmune disorder in which the body’s immune system attacks and destroys its own platelets.

Sometimes this autoimmune response causes damage to megakaryoctyes as well, preventing the production of platelets in the bone marrow. Platelets are responsible for the normal clotting processes of blood. This platelet destruction leads to the inability of blood to clot normally.

ITP can be either an acute or chronic condition. Typically acute ITP occurs in children while chronic ITP occurs in adults, however, children can develop chronic ITP as well. Chronic ITP is more prevalent in females than males. Acute ITP normally resolves in children without treatment.

Symptoms Associated with ITP

  • Excessive bruising
  • Prolonged bleeding from cuts/scrapes
  • Rash-like pinpoint reddish-purple spots (petechiae) on the legs
  • Spontaneous nose bleeds
  • Blood in urine/stool
  • Bleeding gums
  • Fatigue
  • Females will also have menorrhagia (heavy menstrual bleeding).

Diagnosis

ITP is typically considered a diagnosis of exclusion. A reduced number of circulating platelets (less than 100,000 per microliter of blood) will be found in those with this disease. Individuals with ITP also experience prolonged bleeding time. However, blood clotting test results (PT and PTT) are normal. Platelet antibodies may be detected as well. These platelet antibodies cause the spleen to destroy the platelets they mark.

Treatment Options

Primary Methods:

  • Prednisone (A glucocorticoid anti-inflammatory steroid)
  • Immunoglobulin replacement therapy (IVIG or SCIG)

Other Treatment Options:

  • Immunosupressants and anti-RhD immunoglobulin (for certain blood types).
  • A splenectomy, surgical removal of the spleen, is often a last resort but can increase the number of platelets by up to 50%.
  • Appropriate and immediate treatment with antibiotics for any infections that may occur is also necessary.

Other Considerations

Individuals with ITP should not take Aspirin or non-steroidal anti-inflammatory drugs (i.e. Ibuprofen, Naproxen) as these drugs can affect platelet function and increase the risk of bleeds.

Tylenol is safe to take because it does not affect platelet function.

Avoid contact sports that may result in severe injuries, especially injuries to the head/brain. Activities like swimming, aerobics, and biking are much safer choices.