Immune thrombocytopenia (or ITP in short) is a condition of blood, in which the body’s own immune cells act against platelets (the small blood cells which play important role in blood clotting processes). This can lead to easy bruising, bleeding from gums, increased bleeding during menses in women, etc.
Let’s see this condition’s basics in a bit more detail.
What is immune thrombocytopenia?
The immune system is the defense and fighting system of the body against pathogens.
Thrombocytopenia is the medical term meaning low platelets. Platelets are blood cells that help the blood clot.
Immune thrombocytopenia (ITP) is a blood disorder in which the immune system destroys platelets and thus people with ITP have a lower-than-normal number of platelets.
What does the ITP affects a person suffering from it?
Due to lower than normal platelets number in ITP, some people can bruise or bleed much more easily than normal.
Who can suffer from ITP, children or adults?
ITP can happen in both adults and children.
In children, it sometimes happens after infection and gets better on its own in them.
However, if an adult develops ITP, they might need medicines to block the immune system so it stops destroying platelets.
What are the symptoms of ITP?
Some people with ITP have no symptoms.
Others can have:
– Easy bruising – A bruise is bleeding under the skin which gives bluish color to the affected skin part. Many people may have seen it during their childhood after falling or trauma. But in ITP, bruising can occur with minimal trauma (which would not lead to bruising otherwise)
– Bleeding – This can include nosebleeds or blood-filled blisters inside the mouth. In females, monthly periods can be very heavy. Sometimes, there can be more serious bleeding, like bleeding in the brain or inside the body.
How is this condition diagnosed?
Complete blood counts (CBC), mainly check three main blood cells which are red blood cells, white blood cells, and platelets. If you get the above-mentioned symptoms, your doctor will do a CBC. It can show that the platelet count is low, suggesting this is the cause of bleeding or bruising. ……………………………………………………………………
Once low platelets are found, the next question arises are the platelets low because of ITP or some other condition?
In children, ITP is a common cause of a low platelet count and children might get better on their own. So there is no further workup needed unless they do not recover or have some other symptoms indicating other diagnoses.
Adults, on the other hand, might have tests to look for the reason for a low platelet count. If no other cause of a low platelet count is found, then the diagnosis might be ITP. Some of the other tests might include:
Lab tests to check for infections or test for other blood disorders.
Bone marrow test – This might be done in older adults. The bone marrow is the cells inside some of your bones. It makes all of the blood cells, including platelets.
What is the treatment of ITP?
Treatment depends on the age, symptoms, and platelet count of the person.
Children with ITP do not need treatment unless they have a lot of bleeding or a very low platelet count. For most children, ITP goes away on its own within 6 months. But doctors follow children with ITP closely to make sure the ITP does not get worse or end up needing treatment.
Adults with a very low platelet count or bleeding will most likely need treatment. If the ITP is mild and there is no bleeding, treatment is usually not needed.
Adults who need treatment are first treated with steroid medicine. Steroids block the immune system and stop it from destroying platelets. Steroids can take several days to work.
People who need a very fast increase in platelet count might be treated with a platelet transfusion or a medicine called intravenous immune globulin (IVIG). IVIG stops the body’s immune system from destroying platelets.
If the ITP doesn’t get better, there are other treatments.
Removal of the spleen by surgery (Splenectomy) – The spleen is part of the body’s immune system. Removing the spleen often stops the immune system from destroying platelets.
Other stronger medicines that block the immune system, such as rituximab.
Medicines that help the body make more platelets.
What precautions ITP patients need to take?
Depending on their platelet count and symptoms, people with ITP might need to:
Avoid certain sports or activities – If your platelet count is very low, it’s important to limit physical activity and not play certain sports, especially contact sports. That’s because accidents can cause bleeding. People can resume their usual sports and activities again when their platelet count gets to a safe level.
Avoid taking certain medicines – Some medicines, such as aspirin and drugs called non-steroidal anti-inflammatory drugs (NSAIDs), make your platelets not work as well. This can make you prone to bleeding. Drugs that thin your blood, or “anticoagulants,” also increase your risk of bleeding.
Your doctor will let you know which prescription and over-the-counter medicines to avoid.
Your doctor may also educate you about the side effects of steroids if prescribes, and precautions to avoid steroid-associated side effects.
The patients who undergo the removal of the spleen need certain vaccines and may also need antibiotics.
Does ITP affect pregnancy?
If you have ITP and want to get pregnant, discuss this with your doctor. Most people with ITP can have a normal pregnancy and delivery. But you might need to be watched more closely or take certain medicines, especially around the time of delivery.
Your baby’s platelet count might need to be tested as well. This is because there is a small chance your baby could also have a low platelet count for a short time after birth. This does not mean the baby has ITP, but it is important to check the baby’s platelet count.
Is ITP curable disease?
In children, the ITP recovers on its own and completely cures.
In adults, however, the disease course is variable. Some people, especially those who were discovered to have low platelets by chance, may not need treatment at all. Others may need treatment for longer durations to keep the body’s immune system under check from destroying platelets. Your doctor will guide you about the treatment options, expected duration of treatment, and follow-up visits.