Immune thrombocytopenia, also known as autoimmune thrombocytopenic purpura (ITP), is a blood platelet disorder. For most adults with ITP, the condition is chronic (lifelong).

The specific symptoms of ITP are affected by your platelet count: The lower your count, the more likely you are to have spontaneous and unexpected bleeding, both internally and externally. Without treatment to correct platelet counts, bleeding can become severe and life threatening.

Many adults with mild ITP don’t need treatment. They can be observed by their doctor and monitored with blood tests. Others might go into remission. The key to preventing complications from untreated ITP is to complete all follow-ups and testing recommended by your doctor.

Learn about some of the most common complications of untreated immune thrombocytopenia.

Cuts and wounds that won’t stop bleeding

Platelets are responsible for helping your blood clot. When you get a cut and apply pressure against the affected area, your platelets are hard at work to stop excessive blood loss.

With ITP, when you have an injury, there aren’t enough platelets available to efficiently stop blood loss. You may continue bleeding or have prolonged bleeding despite applying bandages.

Seek medical help if you are unable to stop a cut from bleeding after 10 minutes. At the very least, the cut may be deep enough to require stitches.

Bleeding from your nose or gums

ITP may be present if you are having nosebleeds that occur more often than usual and take too long to stop. The same goes for bleeding gums. If you notice your gums are bleeding more, and the bleeding seems to go on for longer than usual (for example, during dental work), it’s possible that you’re dealing with a symptom of ITP.

Prolonged menstrual bleeding

Heavy, prolonged bleeding during your period may also be a sign of ITP. Because menstrual cycles can vary, it’s important to pay attention to your personal cycle, and to talk to a doctor if your bleeding is impacting your daily life.

Bruises that happen easily and often

Bruising easily, especially bruising in areas that have not recently been bumped, can be a sign of ITP.

A bruise happens when the veins and capillaries under your skin break, and red blood cells leak out and cause a purple/bluish mark. If you have ITP, this slight bleeding under the skin can happen more often and can go on for longer periods of time.

A rash made up of tiny red dots

Petechiae, or a rash made up of tiny red dots that stay visible even when you press down on the area, occurs when there are areas of hemorrhage right under your skin, such as broken capillaries.

If you notice this rash appearing on your skin and there is no known cause, it’s possible that you are dealing with a symptom of ITP.


Excessive bleeding can increase your risk for anemia. While anemia has a variety of medical causes, in ITP the reason is due to uncontrolled blood loss. Blood can seep into the skin and deeper tissues causing purpura, superficial bruises, or hematomas, which are deep-tissue bruises.

Blood loss can also occur with internal and external bleeding. In women, anemia may also be attributed to blood loss due to heavy menstruation.

Fatigue that interferes with your daily activities

When your red blood cell count gets too low, you may be overcome with fatigue.

While anemia itself can lead to fatigue and irritability, having a chronic autoimmune disease like ITP can increase fatigue as well. Excessive fatigue can make it difficult to maintain your normal daily routine, and it may also increase your risk for injuries.

Internal bleeding

Uncontrolled bleeding from ITP can sometimes affect the brain. This type of bleeding in the brain is also called an intracranial hemorrhage. While potentially fatal, bleeding in your brain from ITP is rare, according to the National Heart, Lung, and Blood Institute.

Gastrointestinal bleeding is another rare form of internal bleeding that could lead to complications.

Blood in your urine or stools

If you notice blood in your urine, stools, or vomit, it’s possible you may have internal bleeding caused by ITP. However, this symptom is less common and is most likely connected to severe forms of the condition.

Reduced life expectancy from related complications

While there is currently no cure for ITP, mortality directly related to the condition is rare, per a 2012 study published in the American Journal of Hematology.

Your life expectancy depends on your treatment plan as well as your risk level for life-threatening complications, such as a brain hemorrhage. Your age, history of internal bleeding, and overall health all play a part in how serious your immune thrombocytopenia may turn out to be.

Refractory ITP is defined as ITP that doesn’t respond well to treatment. While it’s a rare form of the condition, individuals in this group are at the greatest risk for reduced life expectancy due to bleeding and infection.

The takeaway

Immune thrombocytopenia is a chronic autoimmune condition that currently has no cure, but can be managed in a variety of ways. While some individuals may only experience mild symptoms, if the condition isn’t treated properly by a doctor, certain symptoms may become severe.

If you believe you are exhibiting signs of ITP — such as prolonged bleeding and fatigue — the next step should be talking to a doctor. With their help, you can find a diagnosis and a treatment plan that works for you.