What is immune thrombocytopenia?

Immune thrombocytopenia (ITP) is a bleeding disorder characterized by a decrease in the number of platelets in the blood[1]. Platelets are cells in the blood that help stop bleeding. A decrease in platelets can cause easy bruising, bleeding gums, and internal bleeding[10]. ITP is caused by an immune reaction against one’s own platelets[10]. It has also been called autoimmune thrombocytopenic purpura[10].

Symptoms

ITP may have no signs and symptoms. When they do occur, they may include[1]:

• Easy or excessive bruising
• Superficial bleeding into the skin that appears as pinpoint-sized reddish-purple spots (petechiae)
• Bleeding from the gums or nose
• Blood in urine or stools
• Unusually heavy menstrual flows
• Fatigue
• Enlarged spleen

Causes

ITP usually happens when the immune system makes a mistake and attacks and destroys the cells that help blood clot, also known as platelets[1]. Some people’s genes may make them more likely to develop ITP[3]. Viral infections and bacterial infections can also cause ITP[3].

Diagnosis

To diagnose ITP, your doctor will try to exclude other possible causes of bleeding and a low platelet count, such as an underlying illness or medications you may be taking. Blood tests can check the levels of platelets. Rarely, adults might need a bone marrow exam to rule out other problems[4].

Treatment

People with mild ITP may need nothing more than regular monitoring and platelet checks. Children usually improve without treatment. Most adults with ITP will eventually need treatment, as the condition often becomes severe or long term (chronic) [4]. Treatment may include a number of approaches, such as medications to boost your platelet count or surgery to remove your spleen (splenectomy) [4]. Corticosteroids and intravenous gamma globulin are some of the medications used to treat ITP[7]. Laparoscopic splenectomy is as effective as open splenectomy for alleviating patient’s thrombocytopenia, but it has lowered perioperative risks[13].

If you think you have ITP, please consult your doctor for proper diagnosis and treatment.

Sources:

1. Mayo Clinic[1][4]
2. CHOP[2]
3. Cleveland Clinic[3]
4. UCSF Health[7]
5. NCI Dictionary of Cancer Terms[12]
6. Cedars-Sinai[6]
7. Medscape Reference[11]
8. StatPearls[8]
9. Recent advances in treatments of adult immune thrombocytopenia[9]
10. NORD[14]

Citations:
[1] https://www.mayoclinic.org/diseases-conditions/idiopathic-thrombocytopenic-purpura/symptoms-causes/syc-20352325
[2] https://www.chop.edu/conditions-diseases/idiopathic-thrombocytopenic-purpura-itp
[3] https://my.clevelandclinic.org/health/articles/5726-immune-thrombocytopenia
[4] https://www.mayoclinic.org/diseases-conditions/idiopathic-thrombocytopenic-purpura/diagnosis-treatment/drc-20352330
[5] https://www.nhlbi.nih.gov/health/immune-thrombocytopenia
[6] https://www.cedars-sinai.org/health-library/diseases-and-conditions/i/immune-thrombocytopenic-purpura.html
[7] https://www.ucsfhealth.org/conditions/immune-thrombocytopenia/treatment
[8] https://www.ncbi.nlm.nih.gov/books/NBK562282/
[9] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9057657/
[10] https://www.hopkinsmedicine.org/health/conditions-and-diseases/idiopathic-thrombocytopenic-purpura
[11] https://emedicine.medscape.com/article/202158-treatment
[12] https://www.cancer.gov/publications/dictionaries/cancer-terms/def/immune-thrombocytopenia
[13] https://jhoonline.biomedcentral.com/articles/10.1186/s13045-023-01401-z
[14] https://rarediseases.org/rare-diseases/immune-thrombocytopenia/
[15] https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/idiopathic-thrombocytopenic-purpura-itp