ITP: Idiopathic Thrombocytopenic Purpura HF#4787

 

What is ITP?

 

ITP is a disease of the blood in which the body’s immune system attacks its own platelets for an unknown reason.  The immune system attacks platelets by making proteins (antibodies) which attach to platelets, which then are removed from the body by the spleen.  Normally, when you cut yourself, your platelets rush to this spot and form a clot to stop the bleeding.  People with ITP have fewer platelets to stop bleeding and form a clot.  Without platelets, your blood cannot clot normally.  Patients with ITP otherwise have normal blood counts.

 

Types of ITP

 

There are two types of ITP:  acute (short-term) and chronic (long-term).

• Acute ITP most often lasts less than 6 months.  It occurs mainly in children after a viral infection.  This form of ITP often goes away within a few weeks or months and may not require any treatment.
• Chronic ITP may last 6 months or longer, and it is the type of ITP that most commonly affects adults.  Chronic ITP is three times more common in women than men.  Treatment depends on bleeding symptoms and your platelet count.  Mild cases without bleeding symptoms may not require treatment.

 

Symptoms of ITP

 

When you have ITP, you may notice some of these symptoms.

 

• Tiny, red or purple spots on the skin or lining of your mouth (petechiae).  These are caused by bleeding from small blood vessels under the skin.
• Painless, dime-sized bruises on the skin or in the mouth (purpura).
• Nose bleeds.
• Bleeding gums.
• Heavy menstrual bleeding in women.
• Blood in the urine or stool.
• Bleeding in the brain.  This is rare.

 

Treatment for ITP

 

• Children:  ITP often goes away on its own in children.  Children with bleeding symptoms more than mere bruising may need treatment.  Milder cases may only need monitoring of symptoms and blood work to check platelet counts.
• Adults:  ITP tends to remain in adults, although the severity comes and goes.  Medicines and frequent blood work are often needed.

 

Medicines Used to Treat ITP

 

• Steroids such as prednisone help raise the platelet count in the blood by slowing the activity of the immune system.  This medicine is given by mouth.
• Immune globulin – given intravenously.
• Anti-(Rh) D immunoglobulin – given intravenously.
• Rituxan® – given intravenously.
• Nplate® - given subcutaneously
• Other drugs that slow the activity of the immune system may also be necessary in some cases

 

Surgery:  If the medicines do not work or you need to be on high doses of steroids for a long time, your doctor may remove your spleen.  Since the platelets get trapped in the spleen, removing it helps to stop the breakdown.  If you have your spleen removed, you may be more likely to get infections.  Watch for signs of infection such as fever and get treatment promptly.

 

Platelet transfusions may be needed by people who have severe bleeding.

 

Caring for Yourself at Home

 

Talk with your doctor or nurse about what activities are safe for you to do and when it is OK for you to return to work.  Avoid injury that could cause bruising or bleeding.  Be careful to avoid medicines such as aspirin and ibuprofen that can lower platelet counts and cause bleeding.  Be sure to tell your doctor about all medicines that you are taking. 

 

Be aware of the symptoms described above.  If you notice any of them, be sure to call your doctor.  If you have further questions or concerns, call:

 

Hematology Clinic (608) 265-1700

Your Doctor ____________________________.

 

If you live out of the area, call 1-800-323-8942 and ask for the Hematology Clinic at extension 5-1700.

 

Glossary

Idiopathic – cause of the disease or disorder is unknown

Thrombocytopenic – lower than normal number of platelets in the blood

Purpura – purple bruises where bleeding occurs just under the skin

Petechiae – tiny red or purple dots on the skin often seen on the lower legs; may look like a rash

 

The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.

Last Updated: 02/10/2010

Copyright © 02/10/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4787

Print Health Fact For You