What is ITP? Types, Diagnosis and Treatments

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What is ITP?

Idiopathic Thrombocytopenic Purpura or ITP is a disorder that interferes with the body’s ability to control bleeding due to an abnormally low number of platelets in the blood. 

Platelets are important components for blood clotting, and their deficiency can lead to easy bruising, excessive bleeding, and other complications. 

In this article, we will discuss ITP in detail.

What is Idiopathic Thrombocytopenic Purpura?

ITP is a condition characterized by a decrease in the number of platelets, which are small cell fragments important for blood clotting. 

In a healthy individual, platelets clump together to form clots that prevent bleeding. However, in people with ITP, the immune system mistakenly targets and destroys platelets, leading to their reduced count in the bloodstream.

What are the types of Idiopathic Thrombocytopenic Purpura?

ITP can be classified into two main types, which are:

Acute ITP: 

• This condition commonly occurs in children.
• It often occurs after a viral infection.
• The condition usually resolves within six months, sometimes without any treatment.

Chronic ITP:

• This condition is more commonly seen in adults, but can also affect children.
• The condition lasts for more than six months.
• It may require long-term treatment and management.

What are the causes of Idiopathic Thrombocytopenic Purpura?

The exact cause of ITP is not known, and therefore the condition is known as idiopathic.

ITP is classified as a type of autoimmune disorder where the immune system mistakenly attacks and destroys the body’s platelets. This type of destruction is often triggered by antibodies produced by the immune system.

What are the risk factors of Idiopathic Thrombocytopenic Purpura?

Some factors can increase the risk of ITP, which include the following:

• Viral infections like mumps, flu, or rubella
• Genetic factors 
• Use of certain medications and other medical conditions causing thrombocytopenia (low platelets count)

What are the symptoms of Idiopathic Thrombocytopenic Purpura?

The symptoms of ITP may include the following:

• Easy bruising
• Purpura (small purple spots caused by bleeding under the skin)
• Petechiae (tiny red or purple dots on the skin caused by bleeding under the skin surface)
• Prolonged bleeding even with minor cuts
• Nosebleeds
• Bleeding gums
• Heavy menstrual flow
• Fatigue
• Internal bleeding 

How to diagnose Idiopathic Thrombocytopenic Purpura?

ITP diagnosis may be done using the following tests:

• Physical examination: The doctor will evaluate the patient’s symptoms, medical history, and do a physical exam to look for signs of bleeding and bruising.
• Complete blood count (CBC): This test measures the number of platelets in the blood and is important to diagnose ITP. A low platelet count indicates thrombocytopenia.
• Blood smear: A sample of blood is examined under a microscope to check the size and appearance of platelets and rule out other blood disorders.
• Bone marrow examination: In some cases, a bone marrow biopsy may be performed to rule out bone marrow diseases. This test assesses the production of platelets.
• Additional Tests: Some other tests might be performed to rule out infections, autoimmune diseases, or other underlying conditions.

What is the treatment for Idiopathic Thrombocytopenic Purpura?

The treatment for ITP depends on the severity of the condition, the patient’s symptoms, and the individual’s overall health. Treatment options include:

Observation and monitoring: In cases with mild symptoms, especially in children, close monitoring without immediate treatment is often recommended.

Medications: The different types of medications that may be recommended are:

• Corticosteroids: Prednisone and other steroids can reduce the immune system’s attack on platelets.
• Intravenous Immunoglobulin: It can temporarily increase platelet counts by blocking the immune system.
• Rituximab: This medication targets specific immune cells to reduce platelet destruction.
• Thrombopoietin Receptor Agonists: Drugs like romiplostim and eltrombopag stimulate the production of platelets in the bone marrow.

Surgical Options: Surgery may be recommended in severe cases where other treatment options have failed. The surgical treatment option includes:

• Splenectomy: Removal of the spleen may be considered if other treatments fail. The spleen is a primary site of platelet destruction in ITP.

Lifestyle Modifications: Patients are advised to avoid activities that increase the risk of bleeding or bruising. Regular monitoring of platelet levels is also recommended.

Emerging Therapies: New treatments and approaches are continually being developed, including novel immunosuppressants and targeted therapies.

What are the risks of ITP?

When ITP is left untreated, it may lead to the following complications:

• Prolonged bleeding from minor cuts
• Bruising without a known cause
• Internal bleeding like gastrointestinal bleeding and intracranial hemorrhage
• Menorrhagia (heavy menstrual bleeding)
• Excessive bleeding after any surgery 

The risks associated with ITP treatment are:

• Increased risk of infections 
• Weight gain
• Osteoporosis 
• Diabetes  ( Know more about- What is Diabetes? )
• Headache
• Fever
• Kidney problems 
• Liver problems
• Bone marrow fibrosis or other bone marrow problems
• Fatigue
• Anxiety 
• Depression  ( Know more about- What is Depression? )
• Limited physical activities 
• Increased risk of autoimmune disorders
• Thrombosis (blood clot formation)

How to prevent Idiopathic Thrombocytopenic Purpura?

Some tips to prevent ITP are:

• Regular blood tests to monitor platelet counts
• Avoid contact sports and other activities that could lead to bleeding 
• Use protective gear in situations where injury can occur
• Lead a healthy lifestyle by eating a healthy diet, exercising regularly, managing stress, and taking sufficient rest
• Regular vaccinations
• Immediate treatment for any infections 
• Educate yourself about ITP and its management 
• Join support groups to give you guidance

We hope that we were able to answer all your questions about ITP through this article.

If you want more information about ITP, you can contact a good haematologist at the best hospitals like H N Reliance Hospital Mumbai. 

We only aim to give you information through the article and do not recommend any medication or treatment in any way. Only a qualified doctor can give you good advice because no one else is better than them.