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Iris Valera-Larios on ITP blood disorder treatments : What are platelets? There are three types of blood cell which are all formed in the bone marrow; red cells, white cells and platelets. Platelets, which are small and sticky and circulate in the bloodstream provide the inital plug to stop bruising and bleeding after an injury, and stop blood leaking from capilleries. A blood sample is taken to measure the circulating platelets, and in most people there are between 150,000 and 400,000 platelets in every cubic millimetre of blood. However in the USA we simplify this by describing a platelet count of, say, 150 rather than 150,000. Anyone with a count less than 100 would be considered thrombocytopenic (ie. short of platelets).
Immune thrombocytopenia (ITP) is a disorder that can lead to easy or excessive bruising and bleeding. The bleeding results from unusually low levels of platelets — the cells that help blood clot. Formerly known as idiopathic thrombocytopenic purpura, ITP can cause purple bruises, as well as tiny reddish-purple dots that look like a rash. Children may develop ITP after a viral infection and usually recover fully without treatment. In adults, the disorder is often long term. If you don’t have signs of bleeding and your platelet count isn’t too low, you may not need any treatment. If your symptoms are more severe, treatment may include medications to boost your platelet count or surgery to remove your spleen.
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What causes ITP? ITP is an autoimmune disease. In some cases, this is due to a self-reacting antibody binding to the surface of the platelets, causing both to be removed by cells in the spleen and elsewhere. However, other immune abnormalities have been found in some patients with ITP that affect lymphocytes (a type of white cell) or megakaryocytes (the precursor cells of platelets). These differences may help explain why patients vary in their response to treatment. Why some people develop this “autoimmune” process and others do not is not fully understood. In some individuals, a viral infection may act as an environmental trigger to the process and your doctors may test for triggers such as infection when you are first assessed.
Careful review of your medications: Historically, a bone marrow aspiration was required to make a diagnosis of ITP. It may not be absolutely necessary in the face of a positive antiplatelet antibody test, but it is still commonly done to look at the production of platelets and to rule out any abnormal cells the marrow may be producing that could lower platelet counts. A bone marrow aspiration is necessary for a diagnosis if the antiplatelet antibody testing is negative. See additional details at Iris Valera Larios.
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Thrombocytopenia means a decreased number of platelets in the blood. Purpura refers to the purple discoloring of the skin, as with a bruise. ITP is a fairly common blood disorder that both children and adults can develop. There are two forms of ITP: Acute thrombocytopenic purpura. This usually affects young children, ages 2 to 6 years old. The symptoms may follow a viral illness, such as chickenpox. Acute ITP usually starts suddenly and the symptoms usually disappear in less than 6 months, often within a few weeks. Treatment is often not needed. The disorder usually does not recur. Acute ITP is the most common form of the disorder.