What Is ITP?
ITP stands for idiopathic thrombocytopenic purpura. It is a bleeding disorder characterized
by low platelet counts and excessive bruising. It is also called immune thrombocytopenic
purpura because more is being learned about the autoimmune nature of the disease.
In people with ITP, all of the blood cells are normal except for the blood platelets.
Platelets are necessary for the clotting process by clumping together to seal wounds.
A person with too few platelets bruises easily and bleeds for a long time after
being injured. Tiny red dots on the skin, called petechiae might also appear due
to bleeding under the skin. The person might have nosebleeds that are hard to stop,
bleeding in the intestines, or abnormally heavy menstrual cycles.
What Causes ITP?
The cause of ITP is not known. People with ITP form antibodies that destroy their
blood platelets. Normally, antibodies are a healthy response to bacteria or viruses.
In people with ITP, however, the antibodies attack the body’s own blood platelets.
Who Gets ITP?
- Adults
- Children
- Pregnancy induced
ITP in Adults vs. Children
Childhood ITP is usually seen in an otherwise healthy child. The signs are sudden
and worsening bruising, and possibly petechiae which are seen in the dependent areas
such as the buttocks for infants and toddlers, and the legs and feet for older kids.
Approximately, one in every 600-700 children will develop childhood ITP. The peak
occurrence is between the ages of 2-5 years, with equal occurrences between boys
and girls. There is an 80% chance of remission within 6-9 months. The other 20%
will be known as “chronic”, but they too have a chance of remission.
Adult ITP is mainly immune related and most always chronic. There are more women
than men affected. Adults tend to have increasing bleeding and bruising for weeks
or months. Women may see increased menstrual flow. Many tend to have mild thrombocytopenia,
and may only discover it with blood work taken for other reasons.
How is ITP diagnosed?
Possible tests include:
-
Physical Exam
-
Complete blood count or CBC (will include platelet count)
-
Bone marrow aspiration or biopsy to rule out other diseases ( may not be needed)
-
PT and PTT (bleeding times)
How is ITP treated?
-
Steroids
-
IVIG
-
WinRho
-
Watch and wait
-
Spleen removal
-
Avoiding aspirin, ibuprofen, and blood thinning drugs (these are often drugs that
may interfere and lower platelet counts)
What to Expect?
Many children experience a spontaneous remission. Others may require many treatments
and may be diagnosed as chronic (no remission after 6 months). Education is crucial
in the care of a child with ITP. Safety issues to be aware of are:
Activity limitation
Signs and Symptoms of major bleeding
Side effects of treatments (all medicines have some side effects)
Adults also may experience a remission or may continue with chronically low platelet
counts.
Complications
- Severe bleeding
-
Head trauma
A. Severe and sudden headache
B. Vomiting
C. Changes in level of consciousness
If any of the symptoms occur, notify your doctor immediately or call 911.
Important ITP Documents
The information included above is not intended to be used for self diagnosis, or
to replace that of your physician. This information was compiled to simplify an
explanation of this disorder. Please discuss your symptoms with your physician,
and if it is a medical emergency, dial 911.