Idiopathic Thrombocytopenic Purpura (ITP)

Idiopathic Thrombocytopenic Purpura (ITP) is an autoimmune disease in which platelets are coated with large amounts of antibodies, and are subject to increased degradation in the spleen. Idiopathic Thrombocytopenic Purpura is actually a blood disorder characterized by the abnormal decline in the number of platelets in the blood.

Acute idiopathic Thrombocytopenic Purpura

Acute idiopathic Thrombocytopenic Purpura almost always occurs  in children up to ten years. The disease usually begins after the viral infection of upper respiratory tract. The appearance of symptoms is sudden, over several hours, expressed in the form of bleeding in the skin (petechiae, ecchymoses) and mucous membranes of mouth cavity, nose, digestive and urogenital systems. Prognosis is good, the bleeding usually ceases within a few days (maximum of a few weeks) but spontaneous remissions are frequent.

Chronic Idiopathic Thrombocytopenic Purpura

Image @ A.D.A.M.

Chronic idiopathic Thrombocytopenic Purpura is a classic Werlhof disease, it usually appears in young women (usually up to 40 years). The disease begins gradually, with occasional spontaneous bleeding of the skin and mucous membranes. Bleeding is not very abundant, and is expressed in the form of petechiae (dotted bleeding in the skin,), ecchymosis (bruises), prolonged menstrual bleeding, epistaxis (nosebleeds) and other. Disease may be preceded by several years of tendency to bruising or heavy and prolonged menstrual bleeding, with normal plateletst counts.

Course of chronic ITP is characterized by periods of clinical remission and recurrence of bleeding, which alternate each year. Spontaneous recoveries are very rare, unlike with acute ITP.

Idiopathic Thrombocytopenic Purpura Causes

The initiators of the immune mechanism in the acute form of the disease are usually viruses or other infectious agents, and some medicines, nutritional allergens. It is not known what causes the formation of antibodies in chronic purpura.

The Diagnosis of Idiopathic Thrombocytopenic Purpura

The diagnosis is based on clinical findings and laboratory results. The number of platelets is reduced in the blood. Bleeding time is prolonged and increased number of antibodies is present on the platelets,  the lifespan of platelets is shortened.

Idiopathic Thrombocytopenic Purpura Treatment

The basis of treatment consists of corticosteroids and splenectomy (removal of the spleen). Patients who fail to respond to splenectomy should be treated with immunosuppressant. With significant bleeding a supportive therapy of platelets is applied.

In mild forms of the disease medications are not needed, but it is necessary to seek the cause in order to remove it. In severe forms, corticosteroids should be taken in the period of 3 weeks, which can be repeated after 4-6 months, depending on the nature of the disease.
Sometimes it is necessary to do splenectomy, but only with the chronic form of the disease.
The bleeding in the central nervous system could be singled out as the most serious complications of the disease.