Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disease that causes excessive or easy bleeding. If you have ITP, your body’s immune system makes antibodies that attack platelet cells in the blood. Because platelets help blood to clot, reduced numbers of platelets results in easy bruising and bleeding.
ITP occurs in both adults and children. Idiopathic means that the cause is unknown. Children are more likely to develop ITP after a viral infection, and often make a full recovery from the disease. Adults often develop it as a chronic condition; more women than men have ITP.
You may not know that you have idiopathic thrombocytopenic purpura until you begin to bleed frequently. Other symptoms include easy bruising, a rash of small red spots that indicate leaks or breakages in capillaries, bleeding from the gums, increased and heavy nose bleeds, or unusual bleeding from any area of the body, including in the urine or stool.
Any bleeding that doesn’t stop requires immediate medical attention. If applying pressure to the bleeding area doesn’t stop the flow of blood, seek emergency care.
ITP is caused when individuals have a reduced numbers of platelets, which help blood to clot.
When blood vessels in the skin are damaged, often by some sort of blunt trauma, they can leak blood into the surrounding tissues to create a bruise. In most people, the blood clots before too much is leaked, which means bruises are relatively rare and minor. Since people with ITP have reduced platelets and a reduced ability to clot blood, they tend to develop bruises more easily and sustain much more severe bruises than others.
The reason for the reduced amount of platelets is usually the immune system, which can cause healthy platelets to be destroyed. Usually, particularly in children with ITP, the immune system behaves in this way following a viral infection like the flu. However, when ITP occurs in adults, it isn’t always understood why their immune system is malfunctioning. Sometimes an immune disorder appears to trigger the condition, but in many cases, the cause remains unknown.
Some types of over-the-counter and prescribed medications, including ibuprofen, can impact platelet production. If you take any of these drugs, your doctor will help you find an alternative. You may also be prescribed medication to increase platelet production.
Corticosteroids may be temporarily given to reduce immune system function, but these drugs can have side effects if given long term. Other immune suppressants may be used to achieve the same results.
In severe cases, you may need surgery to remove your spleen. The spleen is where most of the platelets in your blood are destroyed, so taking it out can help increase platelet count. However, not having a spleen can increase your chances of developing infections throughout your lifetime.
There doesn’t appear to be a proven method for preventing ITP. However, individuals with the condition can try to prevent complications by adjusting some key lifestyle factors.
Firstly, it’s important to avoid taking part in activities which could cause injury, as the severity of injuries is likely to be much higher. Contact sports in particular, such as football and boxing, are most risky.
Secondly, consult your doctor about whether or not you should drink alcohol. Alcohol inhibits the production of platelets even further, and can therefore further reduce the body’s ability to clot blood. Depending on how low your platelet counts are, you may be able to drink a moderate amount of alcohol, but always check with your doctor.
Finally, avoid using over-the-counter medications such as aspirin and ibuprofen, both of which impair normal function of platelets. Again, consult your doctor for advice on OTC medications which are safe for you.