Immune thrombocytopenic purpura (ITP) is a blood disorder characterized by a decrease in the number of platelets in the blood. Platelets are cells in the blood that help stop bleeding. A decrease in platelets can cause easy bruising, bleeding gums, and internal bleeding. This
disease is caused by an immune reaction against one's own platelets. It has also been called autoimmune thrombocytopenic purpura. ITP is a fairly common blood disorder that both children and adults can develop. There are two forms of ITP:
What causes idiopathic thrombocytopenic purpura?In ITP, the immune system is stimulated to attack your body's own platelets. Most often this is a result of antibody production against platelets. In a small number of cases, a type of white blood cell called T-cells will directly attack platelets. This immune system error may be a result of any of the following:
What are the symptoms of idiopathic thrombocytopenic purpura?Normal platelet count is in the range of 150,000 to 450,000. With ITP, the platelet count is less than 100,000. By the time significant bleeding occurs, you may have a platelet count of less than 10,000. The lower the platelet count, the greater the risk of bleeding. Because platelets help stop bleeding, the symptoms of ITP are related to increased bleeding. However, each person may experience symptoms differently. Symptoms may include:
The symptoms of ITP may look like other medical problems. Always consult your health care provider for a diagnosis. How is idiopathic thrombocytopenic purpura diagnosed?In addition to a complete medical history and physical exam, you may have these tests:
Historically, a bone marrow aspiration was required to make a diagnosis of ITP. It may not be absolutely necessary in the face of a positive antiplatelet antibody test, but it is still commonly done to look at the production of platelets and to rule out any abnormal cells the marrow may be producing that could lower platelet counts. A bone marrow aspiration is necessary for a diagnosis if the antiplatelet antibody testing is negative. How is idiopathic thrombocytopenic purpura treated?Specific treatment for idiopathic thrombocytopenic purpura will be determined by your health care provider based on:
When treatment is necessary, the two most common forms of immediate treatment are steroids and intravenous gamma globulin:
Other treatments for ITP may include:
Key points about immune thrombocytopenic purpura
Next stepsTips to help you get the most from a visit to your health care provider:
Which diagnostic test can detect destruction of circulating platelets as the cause of thrombocytopenia?Bone marrow biopsy is indicated in conditions when the cause of thrombocytopenia is unclear, and when a hematologic disorder is suspected. A normal number or rise in megakaryocytes in bone marrow is a presenting feature in conditions with increased platelet destruction.
What tests detect thrombocytopenia?A complete blood count (CBC) measures the levels of red blood cells, white blood cells, and platelets in your blood. For this test, a small amount of blood is drawn from a blood vessel, usually in your arm. If you have thrombocytopenia, the results of this test will show that your platelet count is low.
What is the most common cause of thrombocytopenia?Thrombocytopenia has many causes. One of the most common causes of low platelets is a condition called immune thrombocytopenia (ITP). You may hear it called by its old name, idiopathic thrombocytopenic purpura.
What laboratory finding would you expect to see on a CBC for thrombocytopenia?CBC: On a CBC, platelet count < 150,000 per µm3 is considered as thrombocytopenia.
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