Idiopathic thrombocytopenic purpur... Health Article

Definition

Idiopathic thrombocytopenic purpura is a bleeding disorder in which the immune system destroys platelets, which are necessary for normal blood clotting. Persons with the disease have too few platelets in the blood.

ITP is sometimes called immune thrombocytopenic purpura.

Alternative Names

Immune thrombocytopenic purpura; ITP

Causes, incidence, and risk factors

ITP occurs when certain immune system cells produce antibodies against platelets. Platelets help your blood clot by clumping together to plug small holes in damaged blood vessels.

The antibodies attach to the platelets. The spleen destroys the platelets that carry the antibodies.

In children, the disease sometimes follows a viral infection. In adults, it is more often a chronic (long-term) disease and can occur after a viral infection, use of certain drugs, pregnancy, or an immune disorder.

ITP affects women more frequently than men, and is more common in children than adults. The disease affects boys and girls equally.

Symptoms

• Abnormally heavy menstruation
• Bleeding into the skin causes a characteristic skin rash called pinpoint red spots or petechial rash
• Easy bruising
• Nosebleed or bleeding in the mouth

Signs and tests

Laboratory tests will be done to see how well your blood clots and to check your platelet count.

• A complete blood count (CBC) shows a low number of platelets.
• Blood clotting tests (PTT and PT) are normal.
• Platelet associated antibodies may be detected.

A bone marrow aspiration or biopsy appears normal.

Treatment

In children, the disease usually goes away without treatment. Some children, however, may need treatment.

Adults are usually started on an anti-inflammatory medicine called prednisone. In some cases, surgery to remove the spleen (splenectomy) is recommended. This can help increase the platelet count in about 50% of patients. However, other drug treatments are usually recommended instead.

If the disease does not get better with prednisone, other treatments may include:

• A medicine called danazol (Danocrine) taken by mouth
• Injections of high-dose gamma globulin (an immune factor)
• Drugs that suppress the immune system
• Filtering antibodies out of the blood stream
• Anti-RhD therapy for people with certain blood types

People with ITP should not take aspirin, ibuprofen, and warfarin because these drugs interfere with platelet function and blood clotting, and bleeding may occur.