Idiopathic Thrombocytopenic Purpura: Causes, Symptoms, Diagnosis, Treatment, and Prevention
As a result of idiopathic thrombocytopenic purpura (ITP), the blood counts drop and bruising and bleeding are easy. In ITP, the immune system mistakenly attacks and destroys platelets, which increases bleeding risk. Despite the fact that ITP can affect anyone, young women are more likely to suffer from it.
Causes of ITP
The exact cause of ITP is unknown. It is called idiopathic because no specific cause can be identified. However, some factors that may trigger or worsen ITP include:
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Viral infections, such as flu or mumps
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Autoimmune diseases, such as rheumatoid arthritis or lupus
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Certain medications, such as aspirin or antibiotics
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Pregnancy or childbirth
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Spleen problems, such as enlargement or removal
Symptoms of ITP
ITP may not cause any symptoms in some people. However, when symptoms occur, they may include:
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Easy bruising or bleeding from minor injuries
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Purple spots or patches on the skin (petechiae)
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Larger bruises or bleeding on the skin (purpura)
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Bleeding from the gums or nose
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Blood in urine or stools
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Heavy menstrual flow
Diagnosis of ITP
To diagnose ITP, your doctor will perform a physical exam and ask about your medical history and symptoms. You will also need to have some blood tests to check your platelet count and other blood cells. These tests may include:
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Complete blood count (CBC), which measures the number and types of blood cells in your sample
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Blood smear, which examines the shape and size of your blood cells under a microscope
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Bone marrow biopsy, which involves taking a small sample of bone marrow from your hip bone and examining it for signs of abnormal platelet production
Treatment of ITP
It depends on how severe the symptoms are and how low your platelet count is. Some people with mild cases may not need any treatment and only need regular monitoring by their doctors. Others may need treatment to prevent serious complications from bleeding.
The main treatment options for ITP are:
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Corticosteroids (e.g., dexamethasone), immunoglobulins (e.g., intravenous immunoglobulin), anti-D immunoglobulin (for Rh-negative people), or thrombopoietin receptor agonists (e.g., romiplostim) suppress the immune system or stimulate platelet production.
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Platelet transfusions, which involve receiving donated platelets through a vein when you have severe bleeding or low platelet count
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Splenectomy (surgical removal of the spleen), which is usually done for people who have severe chronic ITP that does not respond to other treatments and who have frequent episodes of bleeding due to splenic destruction of platelets
Prevention of ITP
There is no sure way to prevent ITP from developing. However, some steps that may help reduce your risk include:
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Avoiding overuse of medications that affect platelet count, such as aspirin or ibuprofen
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Taking vitamin K supplements if you have low levels of this nutrient in your body
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Eating foods rich in vitamin K, such as leafy green vegetables (e.g., spinach), whole grains (e.g., brown rice), nuts (e.g., almonds), seeds (e.g., sunflower seeds), eggs (especially yolks), cheese (especially hard cheese), liver (especially beef liver), and fish oil supplements
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Avoiding foods that interfere with vitamin K absorption or metabolism, such as milk products (especially dairy products), soy products (especially tofu), quinine-containing tonic water drinks
