What is Idiopathic Thrombocytopenic Purpura (ITP)

Idiopathic thrombocytopenic purpura is a disease in which the body’s disease-fighting system (immune system) attacks platelets in the body. Platelets are blood cells that clump together to form clots. Blood clots help stop bleeding in the body.

A person with ITP has too few platelets. As a result, it is harder for the blood to clot. A person may bruise and bleed easily, such as bleeding a lot from minor cuts and scrapes. ITP can affect both children and adults. It is usually a short-term (acute) condition in children and a long-term (chronic) condition in adults.

What are the causes?

The cause of ITP is not known. In some cases, this condition may develop:

• After a viral infection.
• During pregnancy.
• After developing an immune system disorder.

What increases the risk?

You may be more likely to develop this condition if you:

• Are female.
• Are 20–50 years old.

What are the signs or symptoms?

If you have a mild case, you may not have any symptoms. In more serious cases, symptoms may include:

• Bruising easily.
• Minor injuries, like cuts and scrapes, that bleed for a long time.
• Small red or purple dots under your skin (petechiae), especially on your shins.
• Blood in the urine or stool (feces).
• Nosebleeds.
• Bleeding gums.
• Heavy menstrual periods in women.

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms and medical history.
• A physical exam.
• Blood tests.
• Tests of the spongy tissue inside your bones (bone marrow).

How is this treated?

Treatment depends on how severe your condition is. Treatment may include:

• Monitoring your symptoms and your platelet count over time. You may need to see your health care provider for blood tests on a regular basis.
• Receiving donated blood products (transfusions), such as platelets.
• Medicines to:
  • Reduce inflammation (steroids).
  • Increase how many platelets your body makes.
  • Reduce the activity of your immune system.
• Surgery to remove your spleen, if other treatments are not effective. The spleen is an organ in your upper left abdomen. It stores blood cells and is involved in some immune system functions. In ITP, the spleen releases proteins (antibodies) that mistakenly attack platelets.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider. Do not take the following unless your health care provider approves:
  • Over-the-counter medicines that contain aspirin.
  • NSAIDs such as ibuprofen and naproxen.
• Talk with your health care provider before you take any new medicines. Certain medicines may increase your risk for dangerous bleeding.

Preventing falls

• Follow instructions from your health care provider about ways that you can help prevent falls and injuries at home. These may include:
  • Removing loose rugs, cords, and other tripping hazards from walkways.
  • Installing grab bars in bathrooms.
  • Using night-lights.

General instructions

• Tell all your health care providers, including your dentist, that you have a bleeding disorder. Make sure to tell providers before you have any procedure done, including dental cleanings.
• Do not play contact sports or do activities that have a high risk for injury or bruising. Ask your health care provider what activities are safe for you.
• Brush your teeth using a soft toothbrush.
• When shaving, use an electric razor instead of a blade.
• Wear a medical alert bracelet that says that you have a bleeding disorder. This can help you get the treatment you need in case of emergency.
• Keep all follow-up visits as told by your health care provider. This is important. You may need regular blood tests.

Contact a health care provider if you have:

• New symptoms.
• Symptoms that get worse.
• A fever.

Get help right away if you have:

• A sudden, severe headache.
• Sudden, severe nausea.
• Severe bleeding.
• Vomiting.

Summary

• Idiopathic thrombocytopenic purpura (ITP) is a disease in which the body’s disease-fighting system (immune system) attacks blood cells that form clots to help stop bleeding in the body (platelets).
• ITP can lead to bruising and bleeding easily, including frequent nosebleeds, blood in the urine or stool, and bleeding gums. In women, ITP can lead to heavy menstrual periods.
• Treatment depends on how severe your condition is. It may include steroid therapy and medicines that reduce the activity of the immune system. In some cases, surgery is needed to remove the spleen.
• Follow your health care provider’s instructions about taking medicines, preventing falls, restricting some activities, and when to get help.