Idiopathic thrombocytopenic purpura is a bleeding disorder in which the immune system destroys platelets, which are necessary for normal blood clotting. Persons with the disease have too few platelets in the blood.
ITP is sometimes called immune thrombocytopenic purpura.
ITP occurs when certain immune system cells produce antibodies against platelets. Platelets help your blood clot by clumping together to plug small holes in damaged blood vessels.
The antibodies attach to the platelets. The spleen destroys the platelets that carry the antibodies.
In children, the disease sometimes follows a viral infection. In adults, it is more often a chronic (long-term) disease and can occur after a viral infection, with use of certain drugs, during pregnancy, or as part of an immune disorder.
ITP affects women more frequently than men, and is more common in children than adults. The disease affects boys and girls equally.
Laboratory tests will be done to see how well your blood clots and to check your platelet count.
In children, the disease usually goes away without treatment. Some children, however, may need treatment.
Adults are usually started on an anti-inflammatory steroid medicine called prednisone. In some cases, surgery to remove the spleen (splenectomy) is recommended. This will increase the platelet count in about half of all patients. However, other drug treatments are usually recommended instead.
If the disease does not get better with prednisone, other treatments may include:
People with ITP should not take aspirin, ibuprofen, or warfarin because these drugs interfere with platelet function or blood clotting, and bleeding may occur.
With treatment, the chance of remission (a symptom-free period) is good. Rarely, ITP may become a long-term condition in adults and reappear, even after a symptom-free period.
Sudden and severe loss of blood from the digestive tract may occur. Bleeding into the brain may also occur.
Go to the emergency room or call the local emergency number (such as 911) if severe bleeding occurs, or if other new symptoms develop.
The causes and risk factors are unknown, except in children when it may be related to a viral infection. Prevention methods are unknown.
Immune thrombocytopenic purpura; ITP
McMillan R. Hemorrhagic disorders: abnormalities of platelet and vascular function. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 179.
Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; James R. Mason, MD, Oncologist, Director, Blood and Marrow Transplantation Program and Stem Cell Processing Lab, Scripps Clinic, Torrey Pines, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
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