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Idiopathic thrombocytopenic purpura (ITP) |
| Definition: |
| Idiopathic thrombocytopenic purpura (idiopathic means the exact cause of the disease is unkown) is a bleeding disorder characterized by low platelet numbers resulting from platelet destruction by the immune system. |
| Alternative Names: |
| Immune thrombocytopenic purpura; ITP |
| Causes, incidence, and risk factors: |
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The disease occurs when immune system cells called lymphocytes produce antibodies against platelets. The presence of antibodies on platelets leads to destruction in the spleen. Skin hemorrhage, easy bruising, abnormal menstrual bleeding, or sudden and severe loss of blood from the gastrointestinal tract may occur. Usually, no other abnormal findings are present. In children, the disease is sometimes preceded by a viral infection and runs its course without treatment. In adults, it is usually a chronic disease and rarely follows a viral infection. |
| Symptoms: |
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| Signs and tests: |
Tests include:
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| Treatment: |
| In children, the disease often runs its course without treatment. In adults, initial treatment with prednisone is given. A splenectomy (removal of the spleen) is indicated if the person does not respond to prednisone. The spleen is the major site of platelet destruction, so a splenectomy will resolve the thrombocytopenia in most people. Other treatments (when the disease does not respond to initial treatment) are oral danazol, high dose gamma globulin injections, drugs that suppress the immune system, and passage of the blood over a Protein A (Prosorba) column (which filters antibodies out of the blood stream). Anti-RhD therapy, which destroys cells carrying a specific blood cell molecule, is also useful in some people. People with ITP should avoid taking aspirin or ibuprofen, because these drugs interfere with platelet function, and bleeding may occur. |
| Expectations (prognosis): |
| The chance of remission (a symptom-free period) is good with prednisone or a splenectomy. Rarely, ITP may become a chronic ailment in adults and reappear even after remission. |
| Complications: |
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| Calling your health care provider: |
| Go to the emergency room or call the local emergency number (such as 911) if severe bleeding occurs or other new symptoms develop. |
| Prevention: |
| The causes and risk factors are unknown (except in children when it may be related to a viral infection). Therefore, prevention is unknown. |
Reviewed By: Rebecca Elstrom, M.D., University of Pennsylvania Medical Center, Philadelphia, PA. Review provided by VeriMed Healthcare Network.
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