Understanding ITP

Immune thrombocytopenia (ITP) is a rare condition marked by a low number of platelets in your body. Platelets are blood cells produced in the bone marrow, the soft, spongy tissue in the center of large bones. Platelets bind together to form clots, which prevent your body from bleeding excessively. According to the National Heart, Lung, and Blood Institute, normal levels number range from 150,000 to 450,000 platelets/microliter of blood. But for people with ITP, platelet levels fall below 150,000—and sometimes dangerously low. With very low platelet counts, the risk of bleeding goes up. In severe cases, this can be life threatening. ITP is considered acute when it lasts less than six months and chronic (long term) when it persists beyond six months.

Who gets ITP?
Both children and adults can develop ITP, with the acute form occurring mainly in children, sometimes following a viral infection. About 9 in 100,000 Americans are affected by the chronic form, which affects mainly adults, although children and teens may also develop it. And while women are two to three times more likely to develop chronic ITP, the disease can occur in anyone, of any age. ITP does not seem to run in families.

What’s behind it?
Low platelet levels occur when:

  • The body destroys platelets. Your immune system perceives platelets asenemies and attacks them.
  • The spleen holds on to too many platelets. Normally, the spleen stores about a third of the body’s platelets. When platelets are attacked by the immune system, they are removed from the blood and trapped in the spleen, which helps the body fight infection.
  • Your bone marrow doesn’t make enough platelets. A protein made in the liver called thrombopoietin (TPO) stimulates bone marrow cells to make platelets. If not enough TPO reaches the bone marrow, not enough platelets are produced to replace the platelets that have been destroyed.

What are the symptoms?  
ITP symptoms can vary from person to person, and may include:  

  • Tiny red or purple dots on the skin (petechiae)
  • Excessive bruising (purpura)
  • Bleeding too easily from the gums, nose or cuts
  • Bleeding that’s hard to stop

Symptoms may also include: heavy menstrual bleeding; blood in urine or stool; clotted blood under the skin; and coughing up blood clots. Some people with ITP complain of low energy levels.

How is it diagnosed?
Your doctor will take your medical history and rule out potential causes for your symptoms, such as certain medications, infections or other medical conditions. They will also perform a physical exam and order a complete blood count (CBC), a blood test that shows the number of blood cells, including platelets, in blood, as well as a blood smear, in which blood is viewed under a microscope. In rare cases, a bone marrow exam is required. In this exam, a sample of the liquid portion of the marrow is obtained using a hollow needle inserted into the bone and marrow (aspiration) and a sample of the bone tissue and the enclosed marrow is removed also, using a larger needle (biopsy).

The good news
Today’s treatment options mean ITP can be effectively treated. But, be patient. You may need to try more than one treatment before you find the one that keeps your platelet levels at a healthy place for you. Keep reading this guide to learn about the treatment options and lifestyle steps that are helping people with ITP fend off complications and say yes to all the things they love. 

ITP basics
What is ITP?
ITP causes & risk factors
ITP symptoms
ITP diagnosis
Meet your ITP healthcare team
ITP: Questions to ask your doctor


ITP features
Take control of ITP and live the life you love!
Understanding ITP
ITP symptoms and early detection
Platelet counts: know your numbers
Be prepared for an emergency with ITP


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