Immune Thrombocytopenia (ITP)
Immune thrombocytopenia (ITP) is when the body’s immune system attacks and destroys platelets, the blood cells that cause blood clots to form and help control bleeding.
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The immune system produces antibodies that attach to the platelets and destroy them.
This results in a low platelet count, causing easy bruising and internal bleeding, which can be seen as blood blisters in the mucous membranes and purple areas that look like black-and-blue marks on the skin and the outer linings of the organs.
ITP affects women more often than men, and is more common in children than adults.
Symptoms of ITP
Symptoms of ITP include:
- Easy or excessive bruising
- Tiny reddish-purple dots that look like a rash, called petechiae. These little bleeds occur on the shins, mouth and around the eyes.
- Bleeding from the gums or nose
- Blood in urine or stools
- Unusually heavy menstrual flow
ITP may have no visible symptoms.
Treatment and Management of ITP
If there are no signs of bleeding and the platelets count isn’t too low, no treatment may be needed.
ITP has no cure, so medical care for ITP focuses on increasing the platelet count to a safe level to prevent severe bleeding. Many patients will go into remission spontaneously or with treatment.
Corticosteroids such as prednisone or dexamethasone are often prescribed, and can help increase platelet count. In addition, blood platelet transfusions may be necessary to raise the platelet count.
Other initial, or first-line, therapies include:
- Intravenous immunoglobulin
- Platelet growth factors
- B-cell depletion therapy
- Surgical removal of the spleen
If initial treatment is not successful, second-line therapies include:
- Anti-RhoD – an intravenous drug infusion to elevate platelet counts
- Chemotherapy
- Immunosuppressants
- Androgens
Clinical Trial Opportunities for Patients with ITP
UH Seidman Cancer Center has a clinical trial for patients diagnosed with immune thrombocytopenia. Principal investigator for this clinical trial at UH is Ankit Mangla, MD.