Immune Thrombocytopenia Purpura (ITP)

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What is Immune Thrombocytopenia Purpura?

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 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:

  • Acute ITP
    • Lasts less than six months
    • Usually occurs in children
    • Most common type of ITP
  • Chronic ITP
    • Lasts longer than six months
    • Usually occurs in adults

What Causes ITP?

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 material. Organs like the spleen and liver will then remove the tagged 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.

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.

Risk Factors for Developing ITP

Factors that may increase your chances of developing ITP include:

  • Children with a recent viral infection or live virus vaccination
  • Women—2-3 times more likely to get ITP than men
  • Women younger than 40

ITP Symptoms

Both adults and children may notice the following symptoms:

  • Easy bruising
  • Blood in urine or stools
  • Bleeding for longer than normal following an injury
  • Unexplained nosebleeds
  • Bleeding from the gums
  • In adult women, heavier-than-normal menstrual periods
  • Red dots—may occur in groups and resemble a rash
  • Bleeding within the intestinal tract or brain—rare

Diagnosing ITP at UVA

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 tests to:

  • Analyze levels of different blood cells, including platelets
  • Test your blood's clotting ability
  • Look for infections or other medical issues associated with ITP
  • Eliminate other medical conditions

Platelets are created in your bone marrow. If your platelets are low, then your doctor may sample your blood marrow. This is done to eliminate conditions that may be interfering with the production of platelet cells.

Treating Immune Thrombocytopenia Purpura

Treatment for ITP is different for children and adults. ITP is short term in most children, and most 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.

Some treatment options include:

  • Medications
    • Steroids to lower the activity of the immune system. This will decrease the destruction of platelets.
    • Gamma globulin infusions to slow down platelet destruction. An infusion means that it is given by IV or through a shot. It usually works more quickly than steroids.
  • Platelet Transfusion
  • Surgery    
  • Activity Changes

Immune Thrombocytopenia Purpura Prevention    

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:

  • Take precautions in your child's environment. Consider padding an infant's crib or play area.
  • Make sure that older children wear helmets and protective gear when playing sports. This will help to reduce bruising injuries.
  • Consider temporarily stopping contact sports such as football and rough game playing when platelet counts are low.
  • Avoid medications that contain aspirin or ibuprofen. These medicines can reduce platelet activity.