Signs of Idiopathic thrombocytopenia purpura (ITP, low platelets)

Idiopathic Thrombocytopenia Purpura (Itp, Low Platelets)

Description

A disease that causes excessive bleeding secondary to a low number of platelets (thrombocytopenia). Platelets are essential for normal blood clotting and are made in the bone marrow. Most people have more than 150,000 platelets per microliter. Serious bleeding is usually seen when the count drops below 10,000. In ITP the body's immune system attacks and destroys the platelets. The disease can occur in children and adults and usually occurs in children after a viral infection. The disorders resolves in children but can be long lasting (chronic) in adults.

Symptoms

Pinpoint red spots under the skin (petichiae). Purplish bruises on the skin, mouth, or vaginal area (purpura). Bleeding from the nose (epistaxis), from the gums, in the urine (hematuria) or in the bowels. Large bruises (hematomas) can occur with mild trauma. Excessive vaginal bleeding during menstruation. Serious life threatening bleeding can occur after minor injuries.

Tests

A history and physical exam will be done. A complete blood cell count (CBC) will determine the number of platelets. The blood cells will be examined under a microscope. A blood test will be performed to look for antibodies against platelets. A bone marrow biopsy may also be done.

Standard Workup

Treatment

Many patients do not need treatment because the platelet counts remain high enough to prevent any bleeding. These patients are observed closely and may need periodic transfusions if they undergo surgery. When the platelet counts become too low and are associated with bleeding complications the main course of treatment is medical and surgical. Medical treatment consists of steroids and intravenous immune globulin (IVIG). Surgery involves the removal of the spleen (splenectomy). The spleen is the main source of platelet destruction.