ITP is a rare autoimmune disease characterized by the improper functioning or destruction of blood cells called platelets.1 Platelets allow the blood to clot properly and keep blood vessels intact.2 When platelet levels are very low, this can cause dangerous internal bleeding and bruising.1
ITP is diagnosed by process of elimination, as doctors need to rule out other diseases that may cause the low platelet count.2 Once diagnosed, patients might be in one of two phases of disease progression, each with its own potential duration—acute (0-3 months), persistent (3-12 months) or chronic (12 months or longer).3
ITP affects approximately 1 in 50,000 adults each year and is slightly more common among adult women.2,4
People with ITP may sometimes experience one or more of the following symptoms:2
Tiny red or purple dots on the skin (petechiae)
Bleeding too easily from gums, nose, and cuts
Bleeding that’s hard to stop
Blood in stool or urine
A heavier than usual period flow (females)
The potential for decreases in platelet counts may cause emotional distress. Other challenges associated with ITP include fatigue, hindered ability to work, decreased libido and embarrassment due to the visible symptoms of the disease.5
Treating immune thrombocytopenia (ITP)
The main goal of treatment is to increase platelet counts to a healthy and safe level.1 If treatment is required for ITP, it should be tailored to the individual patient. Patients should talk to their doctor about the risks and benefits associated with each treatment option.
A physician may choose one or more of the following treatment options for ITP:2,6,7
Immunosuppressants / steroid pills
Blood product infusions such as intravenous immunoglobulin (IVIg)
Intravenous Anti-(Rh)D immunoglobulin
Platelet growth factor pills or injections
Finding the right treatment and taking medicine as prescribed will help patients manage their chronic ITP and maintain healthy platelet levels. Patients should work closely with their doctor to determine their ideal platelet count.
In the case of extremely low platelet counts, it may become necessary for patients to be admitted into a hospital to receive platelet transfusions to stabilize their levels.7
Questions to ask your doctor
What is ITP?
What phase of ITP do I have?
How will ITP affect my quality of life?
What are the current treatment approaches for managing my ITP?
What are the benefits of each treatment?
What are the side effects of each treatment?
How will each treatment affect me?
How will we know if the treatment is working?
If my disease doesn’t respond to the treatment, what are my options?
What is my ideal platelet count?
How do I check and track my platelet count?
What do I do if my platelet count drops?
Are there other treatments I should consider?
What resources are available to support people living with ITP and their loved ones?
Saleh, Mansoor N., et al. "Safety and efficacy of eltrombopag for treatment of chronic immune thrombocytopenia: results of the long-term, open-label EXTEND study." Blood 121.3 (2013): 537-545.
“Immune Thrombocytopenia.” U.S. National Institutes of Health website. U.S. National Institutes of Health. Web. 2 August 2016.
Imbach, Paul. “Guide to Understanding ITP (Immune thrombocytopenia).” ITP Foundation and ICIS Basel Switzerland. 2011. PDF file.
Fogarty, Patrick F., and Jodi B. Segal. "The epidemiology of immune thrombocytopenic purpura." Current opinion in hematology 14.5 (2007): 515-519.
Mathias, Susan D., et al. "Impact of chronic Immune Thrombocytopenic Purpura (ITP) on health-related quality of life: a conceptual model starting with the patient perspective." Health and quality of life outcomes 6.1 (2008): 1.
Neunert, Cindy, et al. "The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia." Blood 117.16 (2011): 4190-4207.
Kistanguri, Gaurav, and Keith R. McCrae. “Immune Thrombocytopenia.” Hematology/oncology clinics of North America 27.3 (2013): 495–520.