Symptoms of ITP include bleeding or blood clotting, usually after an injury, surgery, or illness. Treatment depends on a person’s platelet count and the severity of their symptoms.
Treatment based on platelet count and bleeding symptoms
Thrombocytopenia is a disorder in which your body cannot produce enough platelets to stop bleeding. It is a chronic disease that affects adults and children. It causes bleeding in different locations inside and outside of the body. It can be a life-threatening illness in severe cases, but in most cases, it does not cause any serious bleeding problems.
In immune thrombocytopenia, the immune system mistakenly treats platelets as foreign. This causes bruising and bleeding, and a person can develop petechiae (small red or purple dots). Petechiae can appear anywhere on the mucosal membranes.
In severe cases, the person with ITP may need surgery to correct bleeding problems. In addition, they may need a platelet transfusion to help prevent bleeding. Patients with ITP may also need to be treated with medication to help increase the number of platelets. These medications can also help reduce the rate of platelet destruction.
A blood smear is required for patients with isolated thrombocytopenia and must be reviewed to verify that the count is within the normal range. Blood tests can also help rule out infection with hepatitis C and other reversible causes. The patient’s medical history, physical examination, and symptoms of bleeding are used in making a diagnosis.
The treatment of ITP depends on the person’s age, the severity of the disorder, and the symptoms. It can be treated in adults with chronic ITP, or in children with acute ITP. In adults, treatment can take longer to see results. However, in children, recovery is usually rapid.
Treatment can include immunosuppressants, which suppress the immune system, as well as platelet transfusions. In children, a spleen can be removed, reducing the rate of platelet destruction. The patient may also need to be treated with hormone therapy, which prevents the menstrual cycle.
The decision to begin treatment depends on the platelet count and symptoms of bleeding. For patients with chronic ITP, treatment can take several months or longer. A person with ITP may need to stay in the hospital for a time to make sure that their platelets are able to heal. Treatment is also dependent on the patient’s overall health.
Symptoms of ITP
Symptoms of immune thrombocytopenia vary depending on the platelet count. If the platelet count is less than 10,000, you are at risk of serious bleeding. You may be prescribed drugs to block platelet destruction, and you may be given a platelet transfusion. If the platelet count is below 20,000, your risk of major bleeding increases.
Bleeding symptoms may develop suddenly, or they may develop over time. You may experience nosebleeds or heavy menstrual bleeding. If the bleeding becomes severe, you may need to be admitted to a hospital. Your healthcare provider may perform additional tests to rule out other illnesses.
Immune thrombocytopenia occurs when the immune system attacks your own platelets. These cells are produced in your bone marrow and help clot blood. Your body normally uses these cells to fight infections and diseases. If you have immune thrombocytopenia, your body’s immune system is not working properly, and you have fewer platelets.
The first sign you may have of immune thrombocytopenia is bleeding. If you bleed regularly, your healthcare provider may suggest a blood test. The number of platelets in your blood can be measured by a microscope. You may also have blood stains in your urine or feces. Normally, the number of platelets ranges from 150,000 to 450,000. If you are diagnosed with immune thrombocytopenia, your provider may prescribe medicine to increase platelet production.
You may also develop purple bruises. These bruises are caused by bleeding from small blood vessels under the skin. They may look like lumps, and they can form tiny dots on the skin.
Your provider may also recommend a procedure called a splenectomy. The spleen is a small organ located in your upper left abdomen. During the procedure, your healthcare provider will remove your spleen to stop the immune system from attacking your platelets.
Your healthcare provider may prescribe other medicines. These may include corticosteroids, which help prevent platelet destruction. These medicines may increase your platelet count, but they may cause side effects. You may also need to take medicines to prevent infections.
You may also have to avoid contact sports, as you may have a higher risk of bleeding. Also, you may need to make changes in your eating habits.
Thrombotic Thrombocytopenic Purpura (ITP) is a rare autoimmune disorder that results in a persistent decrease in platelet counts. It affects a number of different cell lineages, including T cells and megakaryocytes. The disease is caused by antibodies directed at the Rh (Rhesus) locus. It can also result from other causes, including myelofibrosis, infections, aplastic anemia, and hepatitis C.
Treatment for ITP typically involves high-dose glucocorticoids. However, these medications carry risks of relapse and can also cause side effects. Some patients have been cured with a combination of rituximab and dexamethasone. Another treatment option is the use of mycophenolate mofetil, which is commonly used in the UK. This medication can be used in conjunction with glucocorticoids to improve treatment response. However, more research is needed to determine whether mycophenolate mofetil is an appropriate treatment modality for immune thrombocytopenia.
The FLIGHT (Fetal Loss of Platelets Trial) is an international clinical trial that studied the use of rituximab in the treatment of fetal loss of platelets. The 123 patients enrolled were recruited from 26 hematology practices in Germany. The clinical characteristics of the patients included age, sex, and platelet count. All patients were documented using questionnaires at baseline and at two follow-up visits. The majority of patients completed questionnaires at both points. The study’s results show that the disease response and patient experience were correlated.
In addition, patients receiving mycophenolate mofetil reported a lower quality of life than those receiving placebo. However, there are questions as to why this difference occurs. The length of time patients was treated with mycophenolate mofetil may have contributed to this difference. The study also suggests that the use of mycophenolate mofetil is associated with a higher rate of fatigue. The risk of treatment failure decreased with the combination of mycophenolate mofetil and glucocorticoids.
Another study by Masi M looked at the long-term observation of 208 patients with chronic idiopathic thrombocytopenia. The mean age of the patients was 54 years. They were predominantly male (52.4%). The mean platelet count was 7×109/liter. The treatment response was durable over 18 months of follow-up.
Treatment for relapsed ITP depends on a number of factors, including comorbidities, previous treatment, and a patient’s response to treatment. The American Society of Hematology has published guidelines that provide an evidence-based approach for thrombocytopenia.
Inherited vs not inherited
Thrombophlebitis (TP) is a type of bleeding that is often associated with low platelet counts. Platelets are small anucleate cells that circulate in the blood to protect blood vessel integrity. They are also a hemostatic agent. They are produced by megakaryocytes in the bone marrow.
Inherited thrombocytopenia is a group of hereditary disorders that lead to an abnormality of hematopoiesis, resulting in decreased platelet counts and impaired hemostasis. It is caused by mutations in genes involved in megakaryocyte development and maturation. These genes interfere with megakaryocyte maturation and migration, leading to abnormal platelet production and clearance.
Some inherited thrombocytopenias are associated with increased risks of hematologic malignancies. The clinical presentation of these diseases varies and the underlying genetic cause is important. Depending on the severity of the disease, patients may experience prolonged bleeding after trauma or childbirth. The risk of bleeding is increased in women with a history of severe bleeding.
A quantitative bleeding score is a common metric used to assess the severity of the disease. However, it is not an accurate predictor of the risk of bleeding. The test is based on personal medical history and the experience of the treating physician.
An estimated 30% to 70% of new cases of inherited thrombocytopenias remain undiagnosed. This proportion is influenced by the severity of the disease and the extent of prescreening.
New gene platforms have greatly accelerated the discovery of causal genes. Whole genome sequencing (WGS) and whole exome sequencing (WES) are two methods of identifying these genes. Some of these genes have been linked to signaling pathways and others to the cytoskeletal organization. Some variants have been graded as disease-modulating, while others have been graded as unknown significance.
Some inherited thrombocytopenias also involve bleeding diathesis. The severity of the bleeding diathesis depends on the extent of the platelet count fall and the nature of the accompanying functional defects. Bleeding is usually mild, but it can be severe after trauma or childbirth.
Congenital amegakaryocytic thrombocytopenia (CTP) is characterized by severe thrombocytopenia and high thrombopoietin levels. This is caused by a lack of mature megakaryocytes in the bone apex.
Health A to Z. (n.d.). HSE.ie. https://www2.hse.ie/az/
U.S. National Library of Medicine. (n.d.). https://www.ncbi.nlm.nih.gov/
Directory Health Topics. (n.d.). https://www.healthline.com/directory/topics
Health A-Z. (2022, April 26). Verywell Health. https://www.verywellhealth.com/health-a-z-4014770
Harvard Health. (2015, November 17). Health A to Z. https://www.health.harvard.edu/health-a-to-z
Health Conditions A-Z Sitemap. (n.d.). EverydayHealth.com. https://www.everydayhealth.com/conditions/