Immune thrombocytopenic purpura (ITP)
Immune thrombocytopenic purpura (ITP) is a bleeding disorder in which the immune system destroys platelets, which are necessary for normal blood clotting. People with the disease have too few platelets in the blood.
Bleeding disorder
Bleeding disorders are a group of conditions in which there is a problem with the body's blood clotting process. These disorders can lead to heavy a...
Read Article Now Book Mark ArticleCauses
ITP occurs when certain immune system cells produce antibodies against platelets. Platelets help your blood clot by clumping together to plug small holes in damaged blood vessels.
Antibodies
An antibody is a protein produced by the body's immune system when it detects harmful substances, called antigens. Examples of antigens include micr...
Read Article Now Book Mark ArticleThe antibodies attach to the platelets. The body destroys the platelets that carry the antibodies.
In children, the disease sometimes follows a viral infection. In adults, it is more often a long-term (chronic) disease and can occur after a viral infection, with use of certain medicines, during pregnancy, or as part of an immune disorder.
ITP affects women more often than men. It is more common in children than adults. In children, the disease affects boys and girls equally.
Symptoms
ITP symptoms can include any of the following:
- Abnormally heavy periods in women
- Bleeding into the skin, often around the shins, causing a skin rash that looks like pinpoint red spots (petechial rash)
Bleeding into the skin
Bleeding into the skin can occur from broken blood vessels that form tiny red dots (called petechiae). Blood also can collect under the tissue in la...
Read Article Now Book Mark Article - Easy bruising
- Nosebleed or bleeding in the mouth
Exams and Tests
Blood tests will be done to check your platelet count.
Platelet count
A platelet count is a lab test to measure how many platelets you have in your blood. Platelets are particles in the blood that help the blood clot. ...
Read Article Now Book Mark ArticleA bone marrow aspiration or biopsy may also be done.
Bone marrow aspiration
Bone marrow is the soft tissue inside bones that helps form blood cells. It is found in the hollow part of most bones. Bone marrow aspiration is th...
Read Article Now Book Mark ArticleBiopsy
A bone marrow biopsy is the removal of marrow from inside bone. Bone marrow is the soft tissue inside bones that helps form blood cells. It is foun...
Read Article Now Book Mark ArticleTreatment
In children, the disease usually goes away without treatment. Some children may need treatment.
Adults are usually started on a steroid medicine called prednisone or dexamethasone. In some cases, surgery to remove the spleen (splenectomy) is recommended. This increases the platelet count in about half of people. However, other medicine treatments are usually recommended instead.
Splenectomy
Spleen removal is surgery to remove a diseased or damaged spleen. This surgery is called splenectomy. The spleen is in the upper part of the belly, ...
Read Article Now Book Mark ArticleIf the disease does not get better with prednisone, other treatments may include:
- Infusions of high-dose gamma globulin (an immune factor)
- Medicines that suppress the immune system
- Anti-RhD therapy for people with certain blood types
- Medicines that stimulate the bone marrow to make more platelets
People with ITP should not take aspirin, ibuprofen, or warfarin, because these medicines interfere with platelet function or blood clotting, and bleeding may occur.
Support Groups
More information and support for people with ITP and their families can be found at:
- Platelet Disorder Support Association -- pdsa.org/patients-caregivers/support-resources.html
Outlook (Prognosis)
With treatment, the chance of remission (a symptom-free period) is good. In rare cases, ITP may become a long-term condition in adults and reappear, even after a symptom-free period.
Possible Complications
Sudden and severe loss of blood from the digestive tract may occur. Bleeding into the brain may also occur.
When to Contact a Medical Professional
Go to the emergency room or call 911 or the local emergency number if severe bleeding occurs, or if other new symptoms develop.
Reviewed By
Todd Gersten, MD, Hematology/Oncology, Florida Cancer Specialists & Research Institute, Wellington, FL. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Abrams CS. Thrombocytopenia. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 158.
Zeller MP, Ning S, Arnold DM, Gabe C. Diseases of platelet number: Immune thrombocytopenia, neonatal alloimmune thrombocytopenia, and posttransfusion purpura. In: Hoffman R, Benz EJ, Silberstein LE, et al, eds. Hematology: Basic Principles and Practice. 8th ed. Philadelphia, PA: Elsevier; 2023:chap 129.