Idiopathic Thrombocytopenic Purpura (ITP)

What is Idiopathic Thrombocytopenic Purpura?

Idiopathic thrombocytopenic purpura (ITP) is a disorder of the blood characterised by reduced platelet count without a known clinical cause. The disorder affects the number of platelets and not their functions. In ITP, our body produces antibodies against the platelets; hence, it is an autoimmune disorder.

What are its main signs and symptoms?

Since platelets are needed for stopping bleeding, the symptoms of ITP are primarily related to excessive bleeding. The symptoms are mentioned below:

• Tiny red spots under the skin due to bleeding of the small blood vessels (petechiae)
• Easy bruising without any specific cause (purpura)
• Nosebleed
• Bleeding of the gums
• Blood in vomit, stool, or urine
• Bleeding in the head occurs by any head trauma, which can become life-threatening (Read more: Head injury treatment)

What are its main causes?

Although the cause of ITP is not known, the disease involves the following two processes, which result in lower platelet counts:

• First – antibodies destroy the platelets
• Second –  antibodies also destroy the platelet-producing cells in the bone marrow. The protein thrombopoietin (TPO) is essential for the production of platelets. However, the level of TPO does not rise in case of low platelet count.

How is it diagnosed and treated?

The doctor may perform a complete physical examination and relate it to the medical history. He/she may also order for a complete blood count (CBC) to check for platelet counts and urine test to check for any possible infection and assess bleeding time. Bone marrow aspiration is done to rule out the abnormalities in the bone marrow.

The aim of the treatment is to increase the number of platelets in the blood.

• Corticosteroids are used to reduce the inflammation while immunoglobulin is used to increase the platelet count.
• Splenectomy is performed to control the rate of platelet destruction.
• Platelet transfusion is required in severe cases.
• A medicine called Rituxan (rituximab) is used for chronic ITP.