Autoimmune thrombocytopenic purpura is a blood disease that leads to an abnormally low level of platelets in your blood. It is also called immune thrombocytopenia (ITP).
Seattle Cancer Care Alliance (SCCA) offers a full array of services to diagnose and treat this disease and to rule out other causes of low platelets.
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What is ITP?
ITP usually occurs because antibodies produced by your immune system mistakenly attack and destroy your platelets. Platelets are small cells in your blood that are the first step in forming a clot to stop bleeding.
Most often, ITP occurs without any known trigger, although it may follow a viral infection or be associated with other autoimmune disorders. It sometimes occurs along with lymphoma and may be caused by some medications.
There are two forms of the condition: acute and chronic. The acute form is more common in children and rarely lasts more than six months. Treatment is often not needed unless your platelet count is very low or you are bleeding.
The chronic form is more common in adults. It is considered chronic if it lasts for at least 1 year. Chronic ITP may go away and then recur, even after a long remission.
Symptoms and diagnosis of ITP
People with ITP often bleed and bruise easily. You might have spontaneous nosebleeds or gum bleeding when you brush or floss or during dental visits.
Small blood vessels may break, causing purple bruises to appear on your skin. These bruises are called purpura. Sometimes the only evidence of low platelets is the appearance of tiny bruises, or reddish-purple dots called petechiae, usually on the lower legs and ankles. In other cases, the disease can cause more severe bleeding or internal bleeding that’s difficult to stop.
Many patients report fatigue when their platelet counts are low.
Women with ITP may notice unusually heavy menstrual flow.
To diagnose the disease, your doctor will review your personal and family medical history and do a thorough physical exam. They will order blood tests, including a complete blood count (CBC), and other tests to rule out other causes of your symptoms. If other causes seem likely or if your condition doesn’t respond to treatment for ITP, your doctor may order a bone marrow biopsy to learn more about how your body is making blood cells.
Treatment for ITP depends on many factors, including your age and overall health, the severity of your symptoms, your platelet count and your personal preferences. Mild cases may not need any treatment.
First-line treatment is often corticosteroids, like prednisone, or if your platelet count is very low, intravenous gamma globulin, a blood component that can help to raise your platelet count quickly.
If these treatments don’t control the condition, your doctor may suggest other medicines, including thrombopoietin receptor agonists, which can help increase platelet production, or immunosuppressant therapy, such as rituximab (Rituxan, Truxima) or mycophenolate (CellCept, Myfortic).
In very severe cases, doctors may consider surgery to remove your spleen (splenectomy) if other treatments don’t work.
For more information, visit the Platelet Disorder Support Association website.