itp when to see a doctor?
Immune thrombocytopenic purpura (ITP) is a blood disorder characterized by a decrease in the number of platelets in the blood. Platelets are cells in the blood that help stop bleeding. A decrease in platelets can cause easy bruising, bleeding gums, and internal bleeding. This disease is caused by an immune reaction against one's own platelets. It has also been called autoimmune thrombocytopenic purpura.
ITP is a fairly common blood disorder that both children and adults can develop.
There are two forms of ITP:
In ITP, the immune system is stimulated to attack your body's own platelets. Most often this is a result of antibody production against platelets. In a small number of cases, a type of white blood cell called T-cells will directly attack platelets. This immune system error may be a result of any of the following:
Normal platelet count is in the range of 150,000 to 450,000. With ITP, the platelet count is less than 100,000. By the time significant bleeding occurs, you may have a platelet count of less than 10,000. The lower the platelet count, the greater the risk of bleeding.
Because platelets help stop bleeding, the symptoms of ITP are related to increased bleeding. However, each person may experience symptoms differently. Symptoms may include:
The symptoms of ITP may look like other medical problems. Always consult your health care provider for a diagnosis.
In addition to a complete medical history and physical exam, you may have these tests:
Historically, a bone marrow aspiration was required to make a diagnosis of ITP. It may not be absolutely necessary in the face of a positive antiplatelet antibody test, but it is still commonly done to look at the production of platelets and to rule out any abnormal cells the marrow may be producing that could lower platelet counts. A bone marrow aspiration is necessary for a diagnosis if the antiplatelet antibody testing is negative.
Specific treatment for idiopathic thrombocytopenic purpura will be determined by your health care provider based on:
When treatment is necessary, the two most common forms of immediate treatment are steroids and intravenous gamma globulin:
Other treatments for ITP may include:
Chronic ITP varies from person to person and can last for many years. Even people who have serious types of chronic ITP can live for decades. Most people who have chronic ITP can stop treatment at some point and maintain a safe platelet count.
Treatment depends on your platelet count and whether you have any symptoms. In mild cases, you may not need any treatment, and your provider will monitor your condition to make sure that your platelet count does not become too low. If you need treatment, your treatment plan may include medicines and procedures. If your ITP was caused by an infection, treating the infection may help increase your platelet count and lower your risk of bleeding problems.
Medicines often are used as the first treatment for both children and adults.
Corticosteroids, such as prednisone and dexamethasone, are commonly used to treat ITP. These medicines help increase your platelet count. However, steroids have many side effects. Some people relapse (get worse) when treatment ends.
Other medicines used to raise the platelet count include:
Doctors can surgically remove your spleen if necessary. The spleen is an organ in your upper left abdomen. It makes antibodies that help fight infections. In ITP, these antibodies destroy platelets by mistake.
Removing your spleen may raise your risk of infections. Before you have the surgery, your doctor may give you vaccines to help prevent infections. They will explain what steps you can take to help avoid infections and what symptoms to watch for.
