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Immune thrombocytopenia (ITP), also referred to as idiopathic immune thrombocytopenia, is an autoimmune disease, in which low level of circulating platelets leads to a purpuric rash and to increased bleeding tendency. This condition affects both children and adults, and it is worth mentioning that women are at higher risk. In most of the children cases, ITP will disappear within 6 months, as opposed to adults cases, in which ITP is usually chronic. Although the disease is easy to control, in extreme cases it may lead to death. The most popular symptoms include bruises, bleeding from the nose or mouth and excessive menstrual bleeding.
Idiopathic immune thrombocytopenia characteristics
ITP is a disease caused by abnormal functioning of the immune system, leading to the thrombocytes destruction, and thus resulting in low levels of those platelets. Thrombocytes are delivered from bone narrow, and are mainly responsible for blood clotting, that is why its deficiency is unsafe for human organism. Immune thrombocytopenia may affect both children and adults. Incidence during childhood accounts for half of the total cases, and even without medical treatment, 70% of those children will end up with remission in first 6 months. However, ITP in adults is usually chronic, and in addition, women are at higher risk, representing 1:1,5 male-female ratio. Eventually, serious complications due to ITP like bleeding inside the brain, skull or gastrointestinal tract may lead to death.
Immune thrombocytopenia causes and symptoms
It is believed, that this condition is caused by either virus or certain drugs, which may force the immune system to produce antibodies against the platelets. It can also be triggered during pregnancy, which is an explanation of higher incidence among women. What is more, there is an increased risk of fetal or neonatal immune thrombocytopenia, if a woman had or currently have ITP.
The most common symptom is petechiae. Petechiae is a condition, when bleeding inside the skin cause multiple small bruises, and usually it appears on the lower parts of the body. Another sign is purpura, which looks like a rash and often occurs within 2 days.
Popular symptoms include:
- Nose bleeding
- Increased menstrual bleeding
- Gums bleeding
Immune thrombocytopenia diagnosis and treatment
The diagnosis is fairly easy to establish by running a few tests. However, there may be some concerns related to other possible causes, thus sometimes the exact cause needs to be clarified by a specialist. Apart from physical exam, which will reveal visible signs, there are 2 major tests proving the existence of the disease. One of them is complete blood count test (CBC), which will determine the exact amount of platelets. The other test is a bone marrow examination, mostly done by biopsy, although it is rarely performed and is not recommended for children.
The vast majority of the cases do not require any specific treatment. ITP in children often vanish without any medical intervention, and in adults the symptoms usually are not serious. Treatment is needed when the symptoms are intense or may be life threatening. Steroids intake is one of the most popular therapy, since it reduces the aggression of the immune system, and thus it can slowly restore the proper amount of thrombocytes. Being aware of potential side effects, the dose of the steroids is slowly reduced when the level of platelets is rising. Another treatment methods include Anti-D immunoglobulin administration, splenectomy (spleen removal) or stimulating the bone marrow to increase thrombocytes production.