Under the Patient Education Initiative of Wockhardt Hospitals Nagpur, Dr Gunjan Loney,
Consultant – Hematologist and Hemato – Oncologist.
What is ITP? Immune thrombocytopenia (formerly known as idiopathic thrombocytopenic purpura) is a medical term for an autoimmune disorder causing a shortage of platelets and bruising.
Causes: The immune system mistakes the platelets as being foreign and destroys them. It can follow a virus, vaccination or certain medications, but for most people the cause is unknown. These are of three types:
Acute ITP – that arises suddenly
Persistent ITP- if the platelet count remains low after 3 months
Chronic ITP- if the platelet count has not returned to normal after 12 months.
What are platelets? There are three types of blood cell which are all formed in the bone marrow; red cells, white cells and platelets. Platelets, which are small and sticky and circulate in the bloodstream, provide the initial plug to stop bruising and bleeding after an injury. Normal platelet count is between 150 to 400 (x 109/l).
Many people with ITP have a platelet count in single figures. The number of platelets circulating in our bodies fluctuate all the time, and thus no two consecutive platelet counts are likely to be exactly the same either in a healthy person or in an ITP sufferer.
What are the symptoms of ITP? Some people with ITP, especially those with a count over 50, may have no symptoms at all, and their ITP is only noticed during a routine blood test.
Even people with very low counts, can sometimes have few symptoms.
Common symptoms are:
- Petechiae (pinprick rash of blood spots on skin)
- bruising
- nosebleeds
- Gum bleeds
- Black mouth blisters
- Fatigue
- Heavy periods
When to seek help? You should contact the hospital in the following circumstances: A prolonged (over 30 minutes) nosebleed which will not stop despite pinching the nose Prolonged gum bleeding Blood in the faeces or urine A heavy blow to the head Persistent or severe headache with loss of vision, vomiting or drowsiness Very heavy periods (eg. lasting 8 -10 days, changing more than 4-5 pads per day, passing clots on 2 consecutive days)
Diagnosis: ITP is usually diagnosed by a blood test showing that only the platelet count is low, the red blood cells and white blood cells all look normal.
Additional blood tests may be taken at this time to exclude rare clotting or immune diseases that can mimic ITP.
A bone marrow studies may be done if the ITP continues, in which a small sample of bone marrow will be taken under local anaesthetic and examined under the microscope
