Idiopathic Thrombocytopenic Purpura (ITP) Information 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 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, with use of certain drugs, during pregnancy, or as part of 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
• Bleeding into the skin causes a characteristic skin rash that look liked pinpoint red
Exams and Tests Laboratory tests will be done to see how well your blood clots and to check your platelet
• 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 or may show a greater than
normal number of cells called megakaryocytes. These cells are an early form of
Treatment In children, the disease usually goes away without treatment. Some children, however, may need treatment.
Adults are usually started on an anti-inflammatory steroid medicine called prednisone. In
some cases, surgery to remove the spleen (splenectomy) is recommended. This will
increase the platelet count in about half of all 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, or warfarin because these drugs interfere with platelet function or blood clotting, and bleeding may occur.
Outlook (Prognosis) With treatment, the chance of remission (a symptom-free period) is good. Rarely, ITP may
become a long-term condition in adults and reappear, even after a symptom-free period.
Possible Complications Sudden and severe loss of blood from the digestive tract may occur. Bleeding into the brain
When to Contact a Medical Professional Go to the emergency room or call the local emergency number (such as 911) if severe
bleeding occurs, or if other new symptoms develop.
Prevention The causes and risk factors are unknown, except in children when it may be related to a viral infection. Prevention methods are unknown.
References
• McMillan R. Hemorrhagic disorders: abnormalities of platelet and vascular function.
In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 179.
Information sourced from Florida Hospital Health Library,
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