Overview

Idiopathic thrombocytopenic purpura (ITP) is a disorder that can lead to easy or excessive bruising and bleeding. The bleeding results from unusually low levels of platelets — the cells that help blood clot.

Idiopathic thrombocytopenic purpura, which is also called immune thrombocytopenia, affects children and adults. Children often develop ITP after a viral infection and usually recover fully without treatment. In adults, the disorder is often long term.

If you don't have signs of bleeding and your platelet count isn't too low, you may not need any treatment. In rare cases, the number of platelets may be so low that dangerous internal bleeding occurs. Treatment options are available.

Idiopathic thrombocytopenic purpura (ITP) care at Mayo Clinic

Source: http://www.mayoclinic.com

Symptoms

Idiopathic thrombocytopenic purpura (ITP) may have no signs and symptoms. When they do occur, they may include:

• Easy or excessive bruising (purpura)
• Superficial bleeding into the skin that appears as a rash of pinpoint-sized reddish-purple spots (petechiae), usually on the lower legs
• Bleeding from the gums or nose
• Blood in urine or stools
• Unusually heavy menstrual flow

Source: http://www.mayoclinic.com

Causes

In some people thrombocytopenia is caused by the immune system mistakenly attacking and destroying platelets. If the cause of this immune reaction is unknown, the condition is called idiopathic thrombocytopenic purpura. Idiopathic means "of unknown cause."

In most children with ITP, the disorder follows a viral illness, such as the mumps or the flu. It may be that the infection triggers the immune system malfunction.

Increased breakdown of platelets

In people with ITP, antibodies produced by the immune system attach themselves to the platelets, marking the platelets for destruction. The spleen, which helps your body fight infection, recognizes the antibodies and removes the platelets from your system. The result of this case of mistaken identity is a lower number of circulating platelets than is normal.

A normal platelet count is generally between 150,000 and 450,000 platelets per microliter of circulating blood. People with ITP often have platelet counts below 20,000. Because platelets help the blood clot, as their number decreases, your risk of bleeding increases. The greatest risk is when your platelet count falls very low — below 10,000 platelets per microliter. At this point, internal bleeding may occur even without any injury.

Source: http://www.mayoclinic.com

Diagnosis

To diagnose idiopathic thrombocytopenic purpura, your doctor will try to exclude other possible causes of bleeding and a low platelet count, such as an underlying illness or medications you or your child may be taking.

Your doctor will also ask you about your or your child's medical history, perform a physical exam and run one or more of the following tests:

• Complete blood count (CBC). This common blood test is used to determine the number of blood cells, including platelets, in a sample of blood. With ITP, white and red blood cell counts are usually normal, but the platelet count is low.
• Blood smear. This test is often used to confirm the number of platelets observed in a complete blood count. A sample of blood is placed on a slide and observed under a microscope.

• Bone marrow exam. This test may be used to help identify the cause of a low platelet count, though the American Society of Hematology doesn't recommend this test for children with ITP.

Platelets are produced in the bone marrow — soft, spongy tissue in the center of large bones. In some cases, a sample of bone tissue and the enclosed marrow is removed in a procedure called a bone marrow biopsy. Or your doctor may do a bone marrow aspiration, which removes some of the liquid portion of the marrow. In many cases, both procedures are performed at the same time (bone marrow exam).

In people with ITP, the bone marrow will be normal because a low platelet count is caused by the destruction of platelets in the bloodstream and spleen — not by a problem with the bone marrow.

Source: http://www.mayoclinic.com

Complications

A rare complication of idiopathic thrombocytopenic purpura is bleeding into the brain, which can be fatal.

Pregnancy

In pregnant women with ITP, the condition doesn't usually affect the baby. But the baby's platelet count should be tested soon after birth.

If you're pregnant and your platelet count is very low or you have bleeding, you have a greater risk of heavy bleeding during delivery. In such cases, you and your doctor may discuss treatment to maintain a stable platelet count, taking into account the effects on your baby.

Lifestyle and home remedies

If you have idiopathic thrombocytopenic purpura, try to:

• Avoid activities that could cause injury. Ask your doctor which activities are safe for you. Contact sports — such as boxing, martial arts and football — carry a high risk of injury.
• Drink alcohol in moderation, if at all. Alcohol slows the production of platelets in your body. Ask your doctor whether it's OK for you to drink alcohol.
• Watch for signs of infection. If you've had your spleen removed, be alert for any signs of infection, including fever, and seek prompt treatment. Infection in someone who has had a splenectomy may be more severe than in someone who still has a spleen.
• Use caution with over-the-counter medications. Nonprescription drugs such as aspirin and ibuprofen (Advil, Motrin IB, others) can impair platelet function.

Source: http://www.mayoclinic.com

Risk factors

Idiopathic thrombocytopenic purpura can occur in anyone at almost any age, but these factors increase the risk:

• Your sex. Women are two to three times more likely to develop ITP than men are.
• Recent viral infection. Many children with ITP develop the disorder after a viral illness, such as mumps, measles or a respiratory infection.

Source: http://www.mayoclinic.com