Idiopathic thrombocytopenia purpura is an autoimmune disorder that is the result of low platelet counts.
This causes excessive bruising or bleeding in both children and adults.
One per 100,000 people will be diagnosed with idiopathic thrombocytopenic purpura (ITP) annually. The condition typically develops after a viral infection in children and often dissipates without treatment. However, the disorder often is long term in adults.
Although ITP can affect anyone at any age, factors that increase the risk include sex and recent viral infection. ITP may appear after a child has the mumps or influenza, or in those with HIV, hepatitis C or Helicobacter pylori. Experts suggest viral infections may cause the immune system to malfunction and lead to ITP.
A person can have ITP with no symptoms. However, when symptoms do occur, they may include:
- Purpura, or easy/excessive bruising;
- Bleeding from the gums or nose;
- Blood in the stool or urine;
- Abnormal heavy menstrual flow; and
- Petachiae, or bleeding into the skin that looks like a pinpoint-sized red or purple rash.
ITP is diagnosed by physical exam and tests, including complete blood count, blood smear and bone marrow exam. Although children do not normally require any treatment — only monitoring or platelet checks may be required — adults eventually require long-term treatment.
The primary goal of treatment for ITP is to slow platelet destruction and increase platelets. Medications may be given, including an oral corticosteroid, such as prednisone. If this does not help, an injection of immune globulin may be administered. Additionally, thrombopoietin receptor agonists can help with the production of more platelets, and other immune-suppressing therapies such as rituximab (Rituxan; Genentech, Biogen) may reduce the damage caused to platelets. Splenectomy also may be performed.
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