Idiopathic (Immune) Thrombocytopenic Purpura

Idiopathic (Immune) Thrombocytopenic Purpura General Information

Idiopathic (Immune) Thrombocytopenic Purpura, also known under the generic medical terms of Primary Immune Thrombocytopenic Purpura or Autoimmune Thrombocytopenic Purpura, is a hematological disorder in which the patient presents a very low platelet count, which leads to blood clotting difficulties. The platelets or thrombocytes are colorless cells found within the blood composition that are responsible for the formation of blood clots at the location of blood vessel injury. As a direct result of this affection, the patients tend to bleed longer when one of their blood vessels is injured and also they have a tendency to bruise easily. Gum and nose bleeding appear often, and are difficult to stop.

Idiopathic (Immune) Thrombocytopenic Purpura is generally divided into two categories, based on the nature of the affection. These are the chronic and acute types of the disease. The acute variation of the affection is the more common of the two. It is frequently encountered in children that have recently suffered a viral infection, and in such cases the affection heals within 6 months without any long-term consequences. The chronic type of the disease, however, lasts longer than 6 months and is typically encountered in adult patients.

The exact causes of this affection are still being researched, and that is why the name of the condition includes the term “idiopathic”, which translates to “without a known cause”.

Idiopathic (Immune) Thrombocytopenic Purpura Symptoms

Among the symptoms that are generally considered to indicate that the patient’s platelet count is low and thus suggesting a possibility for Idiopathic (Immune) Thrombocytopenic Purpura to set in are generally constant throughout the cases. However, there have been documented cases when the affection did not cause any observable symptoms (in such cases the affection is considered to be asymptomatic), or when the patients experienced several other symptoms along with one or a few of the ones that are common for this condition. It is advised that if you experience any unusual and unpleasant effects, you should immediately consult with your personal health care specialist in order to further investigate on the causes that may be underlining the symptoms and determine what are the appropriate measures to take in that particular situation. Please keep in mind that you may be suffering from a different affection, and you should always consult with your personal health care specialist in order to obtain an exact diagnosis.

In the cases where Idiopathic (Immune) Thrombocytopenic Purpura are present, the patient may experience excessive or easy bruising, bloody urine or stool and will bleed for prolonged periods of time from a damaged blood vessel, including capillaries – which also leads to a prolonged bleeding time on any injury that the patient may sustain. The patient frequently experiences nose or gum bleeding and may present a superficial bleeding in the skin which appears as a multitude of small red-purple spots. Women may have an abnormally large menstrual flow. In the event of surgery, the patient will bleed profusely.

Idiopathic (Immune) Thrombocytopenic Purpura Treatment

Typically, the diagnosis for Idiopathic (Immune) Thrombocytopenic Purpura is placed by eliminating all other possible affections that may cause bleeding and also those that may cause a drop in the platelet count. In order to do so, the examining health care specialist may inquire regarding the patient’s medical history and general health condition, as well as perform a general physical examination of the patient. Apart from that, the doctor may also require a number of other tests that will help confirm the diagnosis. A complete blood count may be performed, to determine the exact numbers for all the cells present in the patient’s blood – in the case of Idiopathic (Immune) Thrombocytopenic Purpura, all the cell counts will be within normal limits except for the platelet count; it is common that the asymptomatic version of the affection is discovered incidentally, when this test is performed for another reason, for example as part of a routine checkup. After the blood cell count, the low number of platelets can be confirmed by performing an examination of a blood sample from the patient under the microscope. If further checking is needed, the examining health care specialist may require a bone marrow examination as well – this test will also help rule out several other medical affections as well, such as leukemia or anemia. Patients affected by Idiopathic (Immune) Thrombocytopenic Purpura should present normal results to this test, as the decrease in the platelet count is not due to a disturbance in their production, but generally to an immune-related destruction of these cells.

In the case of acute Idiopathic (Immune) Thrombocytopenic Purpura, the affection does not typically require any kind of treatment, as it will pass within at most 6 months. Mild chronic cases may not require treatment either; constant monitoring of the patient along with regular platelet checks should be enough to detect any changes in the patient’s condition, and act as needed. However, in more severe cases the consulting physician may opt for prescribing a medication therapy. Occasionally, the patient may need to undergo surgery to alleviate the signs and symptoms of the affection; also, if the patient is following a treatment with drugs that are inhibiting the platelet functions or that are reducing the blood cell counts, such as warfarin, ibuprofen or aspirin.

Drug treatment for patients affected by Idiopathic (Immune) Thrombocytopenic Purpura typically consists of corticosteroids (Prednisone is the drug of choice when treating such cases). They may help raising the thrombocyte count through inhibiting the immune system activity. Generally, this type of treatment lasts for up to six weeks, after which the platelet count should have returned within normal limits. Once the expected result has been reached, the treatment is not stopped abruptly as it may cause harm to the patient. Instead, the doctor gradually reduces the dosage amount until the therapy can be ceased without any risks. Another type of medication that may be administered is intravenous immunoglobulin; however this is typically reserved for emergency situations, as its effect is fast and very effective, however they wear off within a few weeks.

In mild to severe cases, if the patient does not react to corticosteroid treatment, the doctor may recommend surgical treatment, through a splenectomy. Through removing the patient’s spleen the platelet destruction is less intensive, which will lead to a fast improvement of the condition. This operation however is rarely performed in children.