Immune Thrombocytopenia: Causes, Symptoms, and Treatment
Medically reviewed by Achuta Uppu, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Immune Thrombocytopenia?
A hematologist, a doctor who treats blood disorders, usually treats immune thrombocytopenia. Children may see a pediatric hematologist, a blood doctor for children. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is immune thrombocytopenia?
Immune thrombocytopenia, also called ITP, is a bleeding disorder. The immune system destroys platelets, which are necessary for normal blood clotting. People with ITP have too few platelets in the blood.
Platelets are tiny blood cells that stick together to form a plug, called a blood clot, that seals a wound. With a low platelet count, you may have trouble stopping bleeding.
ITP can be acute (short term) or chronic (long term). Acute ITP often lasts less than 12 months and mainly affects children. Chronic ITP lasts 12 months or longer and mostly affects adults.
Symptoms
ITP may not cause any symptoms. It can cause bleeding that is hard to stop.
- Petechiae, which are small, flat red spots under the skin.
- Purpura, which is bleeding under the skin that can cause red, purple, or brownish-yellow spots.
- Easy bruising.
- Nosebleeds or bleeding from the gums.
- Blood in the urine or stool.
- Heavy menstrual bleeding.
- Extreme tiredness.
Causes and who gets it
Problems with the immune system cause ITP. The immune system attacks and destroys the body's platelets by mistake. Why this happens is not known.
Some things can raise the risk of ITP.
- Antibiotics, antiviral medicines, or medicines to treat inflammation.
- Viral or bacterial infections, which can trigger the immune system to destroy platelets.
- Other immune conditions, such as lupus.
In children, ITP sometimes follows a viral infection. In adults, it can occur after a viral infection, after use of certain medicines, during pregnancy, or as part of an immune disorder. Chronic ITP affects women two to three times more often than men.
How doctors diagnose it
Your provider asks about your medical and family history and your symptoms. They also do a physical exam to look for signs of bleeding.
A complete blood count measures your platelet count and the number of other blood cells. A blood smear lets a doctor look at your platelets under a microscope. Bone marrow tests check whether your bone marrow is healthy. You may need them to confirm ITP, especially if treatment is not working.
Treatment
In mild cases, you may not need treatment. Your provider may watch your platelet count to make sure it does not get too low. In children, the disease usually goes away without treatment.
Medicines are often the first treatment for children and adults. Corticosteroids such as prednisone and dexamethasone are commonly used. They calm the immune system, which helps raise the platelet count. Steroids have many side effects, especially when used for a long time.
- Eltrombopag, romiplostim, and avatrombopag, which help the body make more platelets.
- Immunoglobulin, which is given through an IV needle into the bloodstream.
- Rituximab, which helps prevent the spleen from destroying platelets.
- Fostamatinib, which is used when other treatments have not worked.
Doctors can surgically remove the spleen if necessary. Removing the spleen may raise the risk of infections. Platelet transfusions may be given to stop or prevent bleeding in some types of thrombocytopenia.
Ask your doctor before you take aspirin, ibuprofen, warfarin, or other blood thinners. These medicines interfere with platelet function or blood clotting, and bleeding may occur. If you already take one, do not stop it on your own. Your doctor decides.
When to see a doctor
Contact your provider if you have symptoms of a bleeding disorder. Without proper treatment, ITP can cause serious bleeding.
Go to the emergency room or call 911 if you have severe bleeding, bleeding that does not stop when you apply pressure, vomiting blood, a head injury, or sudden weakness, confusion, or severe pain such as a headache. ITP can cause sudden heavy bleeding from the digestive tract and bleeding into the brain.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can order first blood tests, review your medicines, and help with follow-up visits. They can also coordinate care with a hematologist.
Common questions
Does immune thrombocytopenia go away on its own?
Immune thrombocytopenia usually goes away on its own in children. Acute ITP in children often goes away on its own within a few weeks or months and does not return. Chronic ITP can last for many years.
Is immune thrombocytopenia serious?
For most children and adults, it is not a serious condition. Without proper treatment, though, it can cause serious bleeding.
Can immune thrombocytopenia be prevented?
No, it cannot be prevented.
Can I take aspirin or ibuprofen with ITP?
Usually not, so ask your doctor first. Aspirin, ibuprofen, warfarin, and other blood thinners interfere with platelet function or blood clotting, and bleeding may occur. If you already take one, do not stop it on your own. Your doctor decides.
Sources
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
