Immune Thrombocytopenia : Causes-Symptoms-Diagnosis-Treatment

 What Is Immune Thrombocytopenia (ITP)?

Idiopathic thrombocytopenic purpura (ITP) may be a rare disease that causes you to have low protoplasm levels. Platelets are cell fragments that are found within the blood associated unremarkably to facilitate the blood to clot. In individuals with ITP, the body produces antibodies that attack and destroy the platelets. Antibodies are made by cells of the immune system, and are normally a part of our system for fighting infection.

What Is Immune Thrombocytopenia (ITP)?
mmune Thrombocytopenia

Immune thrombocytopenia, or ITP, is an immune disorder where blood doesn’t clot quickly as a result of the body not having enough platelets.

As a result, ITP will cause excessive bruising and harm internally, in addition as on and below the skin.

individuals with ITP usually have several purple bruises called peliosis on their skin or within their mouth as a result of their low protoplasm count. These bruises may seem as pinpoint-sized red or purple dots, reasonably sort of a rash, on the skin, that is termed petechiae.

ITP wants to be called disorder thrombocytopenic purpura, however the name has changed. The condition isn't any longer idiopathic (which suggests that there’s no glorious cause) as a result of researchers currently apprehending the condition is autoimmune, and “purpura” was dropped from the name as a result of the fact that around a common fraction of new diagnosed patients haven't any bleeding.

The condition has an effect ons more or less fifty to one hundred fifty individuals per million, and it will occur in anyone at any age, although it’s additional rife in adults when the age of 60.

Concerning forty p.c of all cases affect children, though it appears to develop most often in youngsters between the ages of two and 4. This can be very true after they’ve been sick with another infectious agent illness, like chickenpox, mumps, and measles.

  1. Circulatory system

  1. Heart

  2. Arteries

  3. Veins

  4. Blood vessels

Medical terms

  • Immune thrombocytopenia (ITP) is a disorder that may result in simple or excessive bruising and hemorrhage. The bleeding results from remarkably low levels of blood platelets — the cells that facilitate blood clot. erstwhile called upset thrombocytopenic purpura, ITP can cause purple bruises, further as small reddish-purple dots that appear as if a rash. kids may develop ITP once a virus infection and frequently recover absolutely while not receiving treatment. In adults, the disorder is usually long term. If you don't have signs of bleeding and your platelet count isn't too low, you'll not want any treatment. If your symptoms are a lot of severe, treatment might embody medications to spice up your blood platelet count or surgery to get rid of your spleen. 
  • Immune thrombocytopenia (ITP) is a condition in which the immune system destroys platelets which are blood cells important for clotting. The cause of ITP is unknown and there's no cure But high-dose steroids can reduce or eliminate symptoms.

in Children Thrombocytopenia is a condition in which platelets (a type of blood cell) are decreased or absent A deficiency of platelets can be either temporary or permanent The disease may occur due to various causes and has several different classifications In immune thrombocytopenic purpura (ITP) the body's immune system attacks the platelets for reasons that are not well understood People experience this autoimmune reaction when their immune system mistakes their own platelet cells for harmful foreign substances such as bacteria or viruses and attacks them in an attempt to destroy them This results in a low number of circulating platelets causing.

Types Immune thrombocytopenia (ITP)

The two main types of ITP:

  • Acute ITP. This type is short term, lasting less than 6 months. It’s the most common form of the disorder in children.

  • Chronic ITP: This long-term form lasts 6 months or longer and is commonly seen in adults, though it can have an effect on every person.

Symptoms Immune thrombocytopenia (ITP)

Normal blood platelet count is within the range of 150,000 to 450,000. With ITP, the platelet count is a smaller amount than 100,000. By the time important harm occurs, you'll have a platelet count of under 10,000. The lower the platelet count, the bigger the danger of bleeding. As a result of platelets facilitating stop bleeding, the symptoms of ITP are concerning augmented bleeding. However, everybody may experience symptoms differently.

Immune thrombocytopenia may have no signs and symptoms. When they do occur, they may include:

  • Easy or excessive bruising

  • Superficial bleeding into the skin that appears as pinpoint-sized reddish-purple spots (petechiae) that look like a rash, usually on the lower legs

  • Bleeding from the gums or nose

  • Blood in urine or stools

  • Unusually heavy menstrual flow

When to see a doctor

Make a briefing together with your doctor if you or your kid develops warning signs that worry you. a hurt that won't stop may be a medical emergency. look for immediate relief if you or your child experiences bleeding that can't be controlled by the same old first-aid techniques, love applying pressure to the area. 

Causes Immune thrombocytopenia (ITP)

Immune blood disorder sometimes happens once your system erroneously attacks and destroys platelets, that are cell fragments that facilitate blood clot. in a verydults, this could be triggered by infection with HIV, liver disease or Helicobacter pylori — the sort of microorganism that causes abdomen ulcers. In most kids with ITP, the disorder follows a microorganism illness, like the epidemic parotitis or the flu.In ITP, the immune system is stirred up to attack your body' own platelets. Most frequently this can be a result of protein production against platelets. In a little variety of cases, a kind of white corpuscle known as T-cells can directly attack platelets. This system error is also a results of any of the following: 

  • Medications (together with over the counter medications) can motivate an hypersensitivity that cross-reacts with platelets.

  • Infections, commonly viral infections, such as the viruses that cause chicken pox, hepatitis C, and AIDS, can spark off antibodies that pass-react with platelets.

  • Pregnancy

  • Immune disorders, such as rheumatoid arthritis and lupus

  • Low-grade lymphomas and leukemias may produce abnormal antibodies against platelet proteins.

  • Sometimes the cause of immune thrombocytopenic purpura is not known.

Risk factors Immune thrombocytopenia (ITP)

ITP is common among young women. The chance seems to be higher in people that even have diseases like rheumy arthritis, lupus and antiphospholipid syndrome.

Can a bone marrow transplant help ITP?

Bone marrow transplants can help people with immune thrombocytopenia (ITP) by replacing their diseased bone marrow with healthy bone marrow The new healthy bone marrow replaces the platelets that were being destroyed by the patient's own immune system.

Is Rituxan used to treat ITP?

Rituxan interferes with the immune system by targeting CD20-positive B cells Specifically Rituxan binds to CD20 proteins on the surface of developing and mature B cells which prevents them from producing antibodies The drug is used in combination with other medications for the treatment of conditions such as rheumatoid arthritis and non-Hodgkin's lymphoma (NHL) However Rituxan is also used for treating idiopathic thrombocytopenic purpura (ITP) when other interventions have failed to work or when a person has a high risk of bleeding ITP is an autoimmune disorder that.

How much does Rituxan cost?

Rituxan is a prescription medication for the treatment of certain cancers It is approved by the Food and Drug Administration for people who are suffering from rheumatoid arthritis plaque psoriasis Sjogren's syndrome or idiopathic thrombocytopenic purpura Common side effects of Rituxan include nausea fever and chills headache and runny nose The price of Rituxan will vary depending on the pharmacy you use to purchase it.

How long does it take Rituxan to work for ITP?

Rituxan (Rituximab) is a monoclonal antibody that helps the immune system to destroy cancer cells It works by attacking the cancer cells but not normal tissues Rituxan takes three to five days to start working so it’s best if used in combination with another medication (such as steroids) which can be started right away.

What are the long term side effects of Rituxan?

Rituxan is used to treat non-Hodgkin's lymphoma advanced cases of chronic lymphocytic leukemia (CLL) rheumatoid arthritis and idiopathic thrombocytopenic purpura Rituxan has been linked with a number of serious side effects including: Fluid retention in the lungs abdomen or around the heart (pleural effusion or pericardial effusion) Swelling inside the heart (pericardial tamponade) that causes difficulty breathing and/or chest pain Blood clots in the veins of your arms legs or lungs (ven.

Complications Immune Thrombocytopenia

A rare complication of immune thrombopenia is hurt into the brain, which may be fatal. If you're pregnant and your living substance count is extremely low otherwise you have bleeding, you have a larger risk of significant bleeding throughout delivery. Your doctor may recommend treatment to keep up a stable platelet count, taking under consideration the consequences on your baby.

Diagnosis Immune thrombocytopenia (ITP)

To diagnose immune thrombocytopenia, your doctor can associate degreed} exclude different attainable causes of hemorrhage and a coffee living substance count, love an underlying ill health or medications you or your kid is also taking. Blood tests will check the amount of platelets. Rarely, adults would possibly like a bone marrow test to rule out other problems.Most of the time ITP has no symptoms and should be discovered through blood tests for an unrelated medical matter.  ITP is designation of exclusion – once a low platelet count has been discovered, a lot of tests are accustomed to rule out the other causes. These tests might include: 

  • Blood exams – inclusive of a complete blood exam (FBE) to check for platelet numbers, to see if there are abnormalities in different blood counts, or to look if the blood cells appearance normal under the microscope

  • Bone marrow biopsy – doctors remove a small pattern of bone marrow through a needle after which they check it in a laboratory. In a person with ITP, the platelets produced within the bone marrow have to be ordinary. This check is not often needed to diagnose ITP, and is used simplest whilst strictly essential (consisting of when there's a few uncertainty of the diagnosis)

  • other tests – to rule out other conditions that may cause a low platelet count, such as acute leukemia and aplastic anemia.

In addition to these checks, doctors diagnose ITP via taking the man or woman’s clinical records and doing a bodily examination.

Treatment Immune thrombocytopenia (ITP)

Treatment for ITP embraces time and shut observation. In some cases, ITP goes away by itself. In cases wherever the protoplasm count is incredibly low or there's proof of bleeding, some kind of treatment ought to be started.  First-line treatments (the most popular treatments,People with gentle immune blood disorder may have nothing over regular observation and platelet checks. kids sometimes improve while not receiving treatment. Most adults with ITP can eventually need treatment, because the condition typically becomes severe or long run (chronic). Treatment could include a variety of approaches, akin to medications to spice up your platelet count or surgery to get rid of your spleen (splenectomy). speak along with your doctor concerning the risks and advantages of your treatment options. Some individuals notice that the side effects of treatment are much more onerous than the results of the sickness itself.


Your doctor can speak with you regarding over-the-counter medications or supplements you're taking and whether or not you wish to prevent victimization any that may inhibit thrombocyte function. Examples embrace aspirin, Nuprin (Advil, Motrin IB, others) and gymnospermous tree biloba.

Medications to treat ITP may include:

  • Steroids. Your doctor will probably begin you on an oral corticosteroid, equivalent to prednisone. Once your protoplasm count is back to a secure level, you'll be able to step by step discontinue taking the drug underneath the direction of your doctor. long-run use of those medications isn't suggested as a result of they'll increase your risk of infections, high blood glucose and osteoporosis. 

  • Immune globulin. If corticosteroids don't help, your doctor may provide you with an associated injection of immune globulin. This drug may additionally  be used if you have got a vital injury or ought to quickly increase your blood count before surgery. The result sometimes wears off during a number of weeks. 

  • Drugs that boost platelet production. Medications like romiplostim (Nplate) and eltrombopag (Promacta) facilitate your bone marrow and turn out additional platelets. These forms of medication will increase your risk of blood clots. 

  • Other drugs. Rituximab (Rituxan, Truxima) helps increase your protoplasm count by reducing the system response that damages your platelets. However, this drug can also scale back the effectiveness of vaccinations, which can be required if you later select surgery to get rid of your spleen. 


If your condition is severe or persists despite initial drug treatment, your doctor might counsel surgery to get rid of your spleen. This quickly eliminates the most supply of protoplasm destruction in your body and improves your platelet count, although it doesn't work for everyone. Living while not having a spleen for good will increase your condition to infection.

Emergency treatment

Although rare, severe injury will occur with ITP. Emergency care typically includes transfusions of protoplasm concentrates. Steroids and antibodies might also run through a tube during a vein. 

Lifestyle and home remedies

If you have immune thrombocytopenia, try to:

  • Avoid contact sports. Depending on your risk of hemorrhage, head impacts throughout sports like boxing, martial arts and soccer may cause bleeding in your brain. ask your doctor regarding what activities are safe for you. 

  • Watch for signs of infection. If you've had your spleen removed, be alert for any signs of infection, as well as fever, and get prompt treatment. Infections are often additional serious in individuals while not spleens. 

  • Use caution with over-the-counter medications. Nonprescription drugs such as aspirin and ibuprofen (Advil, Motrin IB, others) can impair platelet function.

Preparing for your appointment

Because a coffee thrombocyte count might not cause symptoms, the matter is usually discovered after you have a biopsy Associate in Nursing Mother|for an additional|for one more} reason. To diagnose immune thrombocytopenia, your doctor is probably going to order additional blood tests that need drawing a little quantity of blood from a vein in an arm. He or she may additionally  refer you to a specialist in blood diseases (hematologist).

What you can do

Here are some steps you can take to get ready for your appointment:

  • List any symptoms you're experiencing, including those that seem unrelated to the reason for which you scheduled the appointment.

  • List key personal information, including major stresses, life changes, and recent illnesses or medical procedures, such as a blood transfusion.

  • List all medications, vitamins and supplements that you're taking, including doses.

  • Ask a family member or friend to come with you. In addition to imparting help, he or she will write down statistics from your doctor or different hospital body of workers throughout the appointment.

  • List questions to ask your doctor. Preparing a list of questions can help you make the most of your time together.

Questions about ITP may include:

  • How many platelets do I have in my blood?

  • Is my platelet count dangerously low?

  • What is causing my ITP?

  • Do I need more tests?

  • Is this condition temporary or long lasting?

  • What treatments are available, and what do you recommend?

  • What will happen if I do nothing?

  • What are the possible side effects of the treatments you're suggesting?

  • Are there any restrictions that I need to follow?

  • Is there a generic alternative to the medicine you're prescribing?

  • Do you have any brochures or other printed material that I can take with me? What websites do you recommend?

General summary

  1. Your doctor will likely prescribe a combination of steroids and immunosuppressants to help treat your ITP Steroids are anti-inflammatory medications used to treat autoimmune disorders by reducing immune system activity In addition they increase the length of time platelets stay in the bloodstream and prevent them from breaking apart prematurely Immunosuppressants reduce your body's ability to produce antibodies while suppressing the immune system's response to harmful substances.

  2. First line treatment for ITP starts with corticosteroids which are used to suppress B- and T-lymphocyte proliferation Corticosteroids have been shown to have a response rate of 77% but up to 30% of people require 3 or more different agents before they respond Those who do not respond to corticosteroids may be candidates for splenectomy rituximab intravenous immunoglobulin (IVIG) or cyclophosphamide In addition the use of other medications such as prednisone and azathioprine can be tried before moving on to stronger medications such as rituximab and cyclophos.

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