ITP: Idiopathic Thrombocytopenic Purpura
What is
ITP?
ITP stands for idiopathic
thrombocytopenic purpura. "Idiopathic" means that the cause is
unknown. "Thrombocytopenic" means the blood doesn't have
enough platelets. "Purpura" means a person has excessive
bruising. You may also hear ITP called "immune
thrombocytopenic purpura."
In people with ITP, all of the
blood cells are normal except for the blood platelets.
Platelets are the tiny cells that seal minor cuts and wounds
and form blood clots. A person with too few platelets bruises
easily and bleeds for a long time after being injured. Tiny
red dots on the skin, called petechiae (say "pe-TEEK-ee-ay")
might also appear. When the platelet count is very low, the
person with ITP might have nosebleeds that are hard to stop,
or might have bleeding in the intestines.
What causes ITP?
The cause of ITP is not known. People with ITP form
antibodies that destroy their blood platelets. Normally,
antibodies are a healthy response to bacteria or viruses. In
people with ITP, however, the antibodies attack the body's own
blood platelets.
Who
gets ITP?
There are 2
types of ITP. One type affects children, and the other type
affects adults. In children, the usual age for getting ITP is
2 to 4 years of age. Most adults with ITP are young women, but
it can occur in anyone. ITP does not run in families.
How does ITP affect
children?
ITP is
different in children than in adults. Most children with ITP
have a very low platelet count that causes sudden bleeding.
The usual symptoms are bruises and the tiny red dots on the
skin. Nosebleeds and bleeding gums are also common.
How is ITP diagnosed?
Your doctor can diagnose ITP by
asking questions about your health and doing a physical exam.
Your doctor may take a blood sample and look at it under a
microscope.
How is ITP treated in children?
Because most children recover
with no treatment, many doctors recommend just watching them
carefully and taking care of the bleeding symptoms. Children
don't have to go to the hospital if good care is available at
home. However, some doctors recommend a short treatment with
prednisone pills or intravenous infusions (given in a vein) of
gamma globulin to increase the platelet count more quickly.
Both medicines have some side effects.
How does ITP affect adults?
In most adults, ITP lasts much
longer than it does in children. At the time of diagnosis,
most adults have noticed increased bleeding and easy bruising
for several weeks, or even months. In women, increased
menstrual blood flow is a major sign.
Many adults have only mild
thrombocytopenia. In fact, quite a few people have no bleeding
symptoms. They are only diagnosed with ITP when their blood is
checked for another reason and a low blood platelet count is
found.
How is ITP treated in adults?
Treatment of ITP in adults is
aimed at increasing the blood platelet count. This is not the
same as curing the disease. Patients may take prednisone for
several weeks, even a month or longer. However, when the
medicine is stopped, the platelet counts may get low
again.
If prednisone doesn't help
enough, the spleen can be removed. The spleen makes most of
the antibodies that destroy the blood platelets. It also
destroys old or damaged blood cells. In an otherwise healthy
young person, removal of the spleen is not a serious
operation.
What about ITP in pregnant women?
Diagnosing ITP during pregnancy
can be difficult, because platelet counts may be low for other
reasons. About 5% of women have mildly low platelet counts at
the end of a normal pregnancy. The cause of this is unknown.
The platelet count goes back to normal right after
delivery.
A baby born to a mother with ITP
may have a low blood platelet count a few days to a few weeks
after birth. These babies are usually kept in the hospital for
several days for observation (watching to make sure they are
ok) before they go can home.
Other Organizations
Platelet Disorder Support
Association
http://www.itppeople.com
P.O. Box 61533
Potomac, MD
20859
