Immune thrombocytopenia (ITP) is not cancer, although some confuse it with blood cancer (leukemia). If you have a low platelet count (thrombocytopenia), your doctor will first rule out conditions, such as ITP, before thinking of blood cancer. Cancer treatments can also result in ITP.
ITP, formerly called idiopathic thrombocytopenic purpura, is a disorder that causes you to bleed or get bruised easily. This is because of the tendency to bleed in soft tissues due to a very low platelet count.
What are the symptoms of ITP?
You may have immune thrombocytopenia without developing any symptoms. When they do occur, they may include:
- Easy bruising
- Rash with pinpoint-sized reddish-purple spots (petechiae)
- Epistaxis (bleeding from the gums or nose)
- Hematuria (blood in the urine)
- Blood in stools
- Heavy menstrual bleeding
What causes ITP?
ITP is caused by a dysfunctioning immune system, which results in the immune system attacking the body’s cells and platelets and destroying them. Platelets are responsible for blood clotting. When you have an unusually low level of platelets, your blood will fail to clot and you can bleed easily. ITP may be triggered by:
- Human immunodeficiency virus
- Hepatitis
- Helicobacter pylori (the bacteria that leads to stomach ulcers)
- Mumps or flu in children
- Certain drugs
What are risk factors for ITP?
Young women are more likely to develop ITP than men. Certain conditions can increase the risk of developing the condition, including:
How is ITP diagnosed?
Oftentimes, immune thrombocytopenia is diagnosed during a routine blood check-up, if your doctor notices that you have a very low platelet count. Your doctor will ask you about your medication history, as some medications can result in a low blood count.
Your doctor may order a bone marrow examination to rule out other causes of low platelet count, such as leukemia.
How is ITP treated?
ITP requires regular blood check-ups and monitoring. Children usually do not need treatment, but adults may need lifelong treatment because the condition often becomes chronic.
Treatment for ITP may include medications or surgery:
Medications
If you are on over-the-counter medications, such as aspirin and ibuprofen, your doctor may ask you to discontinue them. These medications are known to inhibit platelet function.
- Steroids. Your doctor may prescribe oral steroids pills, such as prednisolone, for short-term use. Long-term use of steroids is not recommended because of side effects including osteoporosis, increase in blood sugar levels, etc.
- Immune globulin. Immune globulin is administered in the form of injections if steroids fail to improve platelet count.
- Bone marrow stimulating drugs. The bone marrow produces more platelets under the influence of the following drugs:
- Nplate (romiplostim)
- Promacta (eltrombopag)
- Monoclonal antibody. Medications that contain monoclonal antibodies, such as Rituxan or Truxima (rituximab), work on the immune system. By interfering with the immune response that destroys platelets, they help increase platelet count.
Surgery
If medications do not help improve platelet count, surgery to remove the spleen (splenectomy) is recommended. As the spleen is where the platelets get destroyed, removing it improves the lifespan of the platelets. However, removing the spleen permanently increases the risk of serious systemic infections.
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Idiopathic Thrombocytopenic Purpura (ITP)
Idiopathic means that the cause of the condition isn't known. Thrombocytopenic means there's a lower than normal number of platelets in the blood. Purpura refers to purple bruises caused by bleeding under the skin. Idiopathic thrombocytopenic purpura (ITP) is a bleeding condition in which the blood doesn't clot as it should. This is due to a low number of blood cell fragments called platelets.
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