Many of the symptoms of immune thrombocytopenia (ITP), previously known as idiopathic thrombocytopenia, stem from a low platelet count leading to excessive bleeding. A normal platelet count is required in order to control bleeding throughout the body. Most of the time the bleeding is contained underneath the skin and appears as a bruise, so you might dismiss the symptoms as something else.
Other symptoms of ITP can be related to more significant internal or external bleeding.
Some of the most common symptoms of ITP may seem unusual. Be on the lookout for the following eight symptoms, and call your doctor with any concerns you might have.
1. Small red bumps on your skin
One of the most common symptoms of ITP is a skin condition called petechiae. These are small red bumps on your skin caused by bleeding from underneath. Petechiae can look like a red rash at first, but the bumps are slightly raised, scattered, and the size of pinpoints. They can also have a purplish tinge. If you notice petechiae or any unusual rash, see your doctor.
2. Unexplained bruises
Bruises are the result of injuries that cause capillaries to break just underneath the surface of the skin. Blood comes out of these broken capillaries, forming a pool. This creates black-and-blue bruises. Bruises become yellow and fade over time as the blood reabsorbs back into the body, and aren’t usually cause for concern.
There can be many reasons for bruising. Seniors are at a higher risk because of the natural thinning of the skin. Herbal supplements and certain medications can also contribute. Sun damage can also be a cause.
However, you might be noticing that you’re bruising a lot more easily, especially on your arms and legs. You might even wake up with bruises, or get new bruises without having been hurt.
Sometimes bruising easily is a symptom of ITP. Low levels of blood platelets can make it more difficult for your blood to clot, causing the skin to bruise even after a minimal injury. Bruises from ITP are called purpura. They are usually purple in color, and they can even appear inside your mouth.
3. Bleeding from your gums
When we think of the word “skin,” the gums may not come to mind at first. ITP can affect this delicate skin too. This is another form of external bleeding. According to the National Heart, Lung, and Blood Institute (NHLBI), gum bleeding from ITP may occur during dental work. Your gums might bleed during a routine teeth cleaning or from other dental procedures. In severe cases, your gums could bleed from brushing and flossing.
It’s possible to attribute this bleeding to gingivitis instead of an ITP symptom. At your cleanings, your dentist may also notice bruises inside of your mouth.
4. Frequent nosebleeds
Nosebleeds (epistaxis) occur when the delicate skin inside of your nose bleeds. These can be relatively common and have a variety of causes, including:
- sinus infections
- medications that thin the blood
The Mayo Clinic defines frequent nosebleeds as those occurring at least once a week. If you find yourself having numerous nosebleeds despite being well and keeping your nose moist, you should see your doctor.
5. Heavier-than-normal periods
Low platelet counts from ITP can even affect your menstrual cycles, making bleeding heavier than usual. While heavy periods might seem more like a nuisance than anything else, they can also lead to complications, such as anemia. An occasional heavy menstrual cycle might not be cause for concern. But if you begin experiencing a heavy period every month, see your doctor.
6. Blood in your urine or stools
The low platelet count associated with ITP can also cause bleeding in your urine or stools. At first, you might mistake urine in the blood as a sign of infection. However, bladder infections often accompany other symptoms, such as:
- lower back or flank (kidney) pain
- frequent urination
- abdominal pain
Blood in the stool is never normal. If you see blood in your urine or stools, follow up with your doctor. It could be a sign of ITP.
ITP can also cause small lumps underneath the skin. These are called hematomas, and they’re made up of areas of clotted blood that pooled in the tissue deep underneath your skin. A hematoma is a type of deep bruise and typically only occurs with a moderate injury. See your doctor for any bumps on the skin or bumps within deeper tissues.
8. Excessive fatigue
Red blood cells transport oxygen throughout the body, which helps your tissues and organs function properly. When you bleed, your body takes time to replace the blood. In cases of moderate bleeding, this can lead to anemia due to fewer-than-needed red blood cells. You might feel overly fatigued as a result. Signs of excessive fatigue include:
- needing more sleep than normal
- requiring daytime naps
- feeling tired during the day despite getting a good night’s sleep
- overall lack of energy for your everyday activities
If you have any signs or symptoms of anemia, make sure to see your doctor.
It’s important to know about the symptoms of ITP. That way if you do experience any of them, you’ll be able to seek medical attention to help keep your symptoms from getting worse. If you do notice any of these symptoms, notify your doctor right away. They’ll be able to make sure you’re receiving the proper diagnosis and treatment.