Immune thrombocytopenia (ITP) is a blood platelet disorder. For most adults with ITP, the condition is chronic (lifelong). The variety of symptoms in ITP is affected by your platelet count. The lower your platelet count is, 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 that are recommended by your doctor.

Read on to learn about the seven most common complications of untreated ITP.

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. You must seek emergency medical help if you don’t stop bleeding.

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 pupura, superficial bruises, or hematomas, 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.

In ITP, bruises are the result of uncontrolled bleeding. These bruises aren’t necessarily caused by an injury. However, you might be taking extra precautions to avoid injury by not participating in your favorite activities. You’ll probably avoid contact sports and other activities that have a high risk for injury — but you don’t necessarily need to avoid all activities. However, you need to see your doctor if you keep getting bruises despite avoiding high-risk activities. This could be a sign of ITP.

When your red blood cell count gets too low, you may be overcome with fatigue. Anemia often leads to fatigue and irritability. However, having a chronic autoimmune disease like ITP can heighten fatigue as well. Excessive fatigue can make it difficult to maintain your normal daily routine, and it also increases your risk for injuries.

Uncontrolled bleeding from ITP can sometimes affect the brain. Bleeding in the brain is also called a brain hemorrhage. This is most likely to occur when platelets get extremely low, less than 20,000 platelets per microliter of blood. When platelets get to 5,000 per microliter of blood or below, this becomes a medical emergency, and immediate intervention is required. 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.

ITP can increase your risk for serious infections, especially if you’ve had your spleen removed. Be on the lookout for early symptoms of an infection. These include:

  • high fever and shaking chills
  • sudden fatigue
  • other flu-like symptoms
  • headaches
  • body aches
  • shortness of breath
  • stiff neck

See your doctor immediately for treatment if you experience these symptoms.

There’s no cure for ITP. However, this doesn’t mean that ITP is fatal. Mortality directly related to ITP is rare, per a study published in the American Journal of Hematology.

Your life expectancy depends on your treatment plan and reduced risks for life-threatening complications, such as a brain hemorrhage. Your age, history of internal bleeding, and overall health are also risk factors to consider.

Refractory ITP is defined as ITP that doesn’t respond well to treatment. This typically is defined by platelet counts that fail to stay above 20,000 platelets per microliter of blood despite spleen removal and multiple medical therapies. Less than 1 out of 10 people with ITP fall into this group. However, this is the group at greatest risk for reduced life expectancy due to bleeding and infection.

ITP is unpredictable. Try to focus on ways to reduce your risk from complications attributed to untreated ITP. Talk to your doctor about treatment options and lifestyle changes that could help you manage your condition.