Pronunciation: ID-ee-oh-PATH-ic Throm-boh-SIGH-toh-peen-ick Pur-PUR-ah
Immune thrombocytopenia purpura (ITP) is a bleeding disorder. It is a reduction in the number of platelets in your blood. Platelets are small cells in your blood that can stick together to form blood clots. These clots help stop bleeding at injury sites. Low platelet levels with ITP makes it easier to develop bruises or bleed even with minor injuries.
There are two types of ITP:
ITP can be treated. If you think you have ITP, call your doctor.
ITP is caused by a problem with the immune system. The immune system places a tag on platelet cells. This tag mistakenly identifies platelets as foreign or "bad" material. Organs like the spleen and liver will then remove the marked platelets as they pass through in the blood. Gradually, this process will reduce the number of platelet in your blood. Eventually, the decreased levels of platelets will be severe enough to interfere with the blood's ability to clot.
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For most ITP, it is not clear what causes the problem with immune system. In children, ITP is often associated with a recent infection with a virus. ITP in adults has not been linked to viruses.
Some cases of ITP are thought to be caused by drugs or other immune disorders.
People with increased chance of developing ITP include:
If you have any of the following, do not assume it is due to ITP. These may be caused by other, less serious health conditions. If you have any one of them, talk to your doctor.
Both adults and children may notice the following symptoms:
Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Blood tests will be done. The doctor may use these test to:
Platelets are created in your bone marrow. If your platelets are low your doctor may sample your blood marrow. This is done to eliminate conditions that may be interfering with the production of platelet cells.
Treatment for ITP is different for children and adults. ITP is short term in most children. Most children will recover without any treatment. Adults are more likely to develop a chronic form of ITP. Not all of these chronic ITPs will require treatment either. Talk with your doctor about the best plan for you.
Some treatment options include:
Medication may help to either slow the destruction of platelet cells or increase production of platelets. The overall goal is to maintain a healthy level of platelets in the blood.
To increase platelet counts in the blood, your doctor may recommend:
Both of these treatments work but both can have side effects.
Two new drugs are being used to stimulate platelet production:
Use of these and a medication called rituximab (Rituxan) may prevent the need for surgery.
A splenectomy may be done if medication is not effective enough.
A splenectomy is the removal of the spleen. The spleen is the main site of platelet destruction. Without your spleen, your platelet levels should begin to improve. However, the missing spleen also makes you more vulnerable to certain infections. This surgery is usually not done until all medication option have been tried.
You may be asked to avoid certain activities when your platelet counts are low. This may include avoiding contact sports or wearing a helmet.
Since the cause of ITP is unknown, there are no specific ways of preventing it. However, bleeding and injury can be serious for people with ITP. To decrease the chance of bleeding injuries:
To help stay healthy, you should:
American Academy of Family Physicians
National Heart, Lung, and Blood Institute
National Institute of Diabetes and Digestive and Kidney Diseases
Canadian Medical Association Journal
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What is immune thrombocytopenia? National Heart Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/itp/ . Updated March 14, 2012. Accessed September 27, 2012.
Last reviewed September 2012 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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