Idiopathic Thrombocytopenic Purpura (ITP) is a rare blood disorder in which your immune system mistakenly destroys platelets.
If you have ITP, you will notice that your skin is easily bruised and bleeding takes longer to stop after minor cuts or injuries.
It can happen to anyone, whether an adult or a child, including pregnant women. Awareness about ITP can help manage the condition promptly and prevent blood loss in case of an emergency. Read more to find out!
What is Idiopathic Thrombocytopenic Purpura?
ITP is an autoimmune disorder that causes your immune system to mistakenly attack its own platelets and reduce the numbers in the bloodstream. Since platelets are crucial for clot formation, their lack can delay healing and prolong bleeding and bruising.
“Idiopathic thrombocytopenic purpura” is the old term that was used when the cause of the disease was not identified. However, in 1951, it was found to be an autoimmune disorder and termed Immune Thrombocytopenic Purpura (ITP).
Idiopathic Thrombocytopenic Purpura Symptoms
ITP symptoms differ based on the severity of platelet deficiency. The common ones are:
- Purple colour bruises on the skin without injury (purpura)
- Red or purple spots on the skin (petechiae)
- Prolonged bleeding from cuts
- Nosebleeds
- Bleeding gums
- Unusually heavy menstrual periods
- Fatigue due to blood loss
- Internal bleeding (rare)
Types of ITP
Experts know that ITP is triggered by an autoimmune response; however, what exactly triggers it is still unknown, according to NCBI. The condition is categorised as:
Primary ITP
When the autoimmune response of ITP occurs without any underlying cause, it is referred to as primary ITP. It is further divided into two types:
- Newly diagnosed or Acute ITP: It typically lasts for up to 3 months after diagnosis, and the symptoms may resolve, often without treatment.
- Persistent or Chronic ITP: The symptoms continue for 3 to 12 months or more.
Secondary ITP
When triggered by other underlying health conditions such as HIV, drug reactions, etc., it is called secondary ITP.
Causes and Triggers
Based on the current understanding about this condition, the Idiopathic Thrombocytopenic Purpura causes and triggers include:
- Autoimmune reaction: Immunoglobulin G (IgG) autoantibodies mistakenly attack platelets, perceiving them as a threat to health.
- Infections: Viral infections, such as hepatitis C, HIV, or other childhood viruses, can trigger ITP. Idiopathic thrombocytopenic purpura in children is mainly due to viral infections like chickenpox. The cases peak between 2 and 5 years of age and adolescence.
- Medications: Nonsteroidal anti-inflammatory drugs, penicillin, quinidine, quinine, ranitidine, antibiotics, and certain chemotherapy drugs may trigger an autoimmune response against platelets.
- Underlying Health Conditions: Individuals with existing autoimmune diseases, such as lupus or rheumatoid arthritis, may be at an increased risk of developing ITP.
- Pregnancy: Some women may get ITP during pregnancy due to immune system changes. Idiopathic thrombocytopenic purpura in pregnancy can complicate delivery; therefore, regular monitoring of the platelet count is crucial for the health of both the mother and the child.
Idiopathic Thrombocytopenic Purpura Diagnosis
While the physical symptoms can indicate the presence of ITP, a combination of blood tests and medical history assessment is required to diagnose it. Take a look:
- Complete blood count (CBC) measures platelet levels.
- Blood smear test to examine the shape and size of platelets.
- Tests to rule out leukaemia, aplastic anaemia, or infections.
- Bone marrow biopsy
Idiopathic Thrombocytopenic Purpura Treatment
In the mild cases of ITP, no treatment is required. The patient is kept under observation and is asked to undergo regular monitoring. The symptoms may subside in a few weeks.
However, for severe cases, the following treatment options are available:
- Medications: Steroids, immunoglobulins, or other immunosuppressing drugs are given to increase platelet counts.
- Platelet transfusions: This is done in cases of severe bleeding.
- Surgery: Splenectomy is done to remove the spleen, where platelets are destroyed, to reduce the body’s immune response/attack and slow down platelet destruction.
- Medication: Rituximab is administered to slow down the production of antiplatelet antibodies, while romiplostim, eltrombopag, and avatrombopag can help stimulate the bone marrow to produce platelets.
Lifestyle adjustments and avoiding medications that can worsen bleeding, along with precautions to prevent injury, are also recommended.
Read More: Blood Transfusion Procedure: Everything You Need to Know
To Sum Up
Idiopathic Thrombocytopenic Purpurais is a potentially serious but manageable condition. Early symptom recognition, timely medical care, and preventing complications can help improve outcomes. Awareness of this disease, particularly in children and pregnant women, is crucial for prompt intervention and effective treatment.
Idiopathic Thrombocytopenic Purpura FAQs
What is the most common cause of ITP?
In most cases, the exact cause is unknown, but in some instances, existing autoimmune diseases, such as lupus, and viral infections in children can trigger it.
What organ is responsible for ITP?
The ITP is caused by an immune response where it mistakenly produces antibodies against platelets, and then these antibody-coated platelets are destroyed by the spleen.
Is ITP caused by stress?
Stress does not directly cause ITP, but studies have shown that mental stress enhances platelet activity, and various patients with post-traumatic stress disorder have comorbidities with autoimmune diseases like rheumatoid arthritis and thyroidism.
At what age does ITP occur?
ITP can occur at any age and to anyone, but cases are common in kids aged 2 to 6 years and women between 30 and 40 years of age.
