Idiopathic Thrombocytopenic Purpura

Question: Idiopathic thrombocytopenic purpura ? I had Idiopathic thrombocytopenic purpura (ITP) when I was about 2 years old. Are there any life-long effects that I should know about?

Answer: Idiopathic thrombocytopenic purpura (ITP) is the condition of having a low platelet count (thrombocytopenia) of no known cause (idiopathic). As most causes appear to be related to antibodies against platelets, it is also known as immune thrombocytopenic purpura. Although most cases are asymptomatic, very low platelet counts can lead to a bleeding diathesis and purpura. Signs and Symptoms ITP occurs most often in women over 40 years of age. It may be acute, lasting for 6 months or less, or chronic, lasting for over a year. The acute type is more often seen in children and will cure itself in more than 80% of cases. The chronic type is more commonly seen in adults and it tends to get worse as the disease progresses. Occasionally, ITP patients suffer from bruising, nosebleeds, and bleeding gums; this is the characteristic pattern of bleeding in platelet disorders. Bleeding normally does not occur unless the platelet count is very low (below about 10,000 per mm3, compared to a normal range of 150,000–400,000 per mm3). Subarachnoid and intracerebral hemorrhage are very serious possible complications of this disease. Fortunately, these are rare in patients who are being treated. Pathogenesis In many cases, the cause is not actually idiopathic but autoimmune, with antibodies against platelets being detected in approximately 80% of patients. Most often these antibodies are against platelet membrane glycoproteins IIb-IIIa or Ib-IX, and are of the IgG type. The coating of platelets with IgG renders them susceptible to opsonization and phagocytosis by splenic macrophages. The IgG autoantibodies are also thought to damage megakaryocytes, the precursor cells to platelets, but this is thought to contribute only slightly to the decrease in platelet numbers. Diagnosis When measuring the platelet count, one has to bear in mind that the "normal values" for laboratory measures are all statistical. They are defined by the upper and lower 2.5th percentile. It is therefore possible to be completely healthy but to have a decreased platelet count. There is, however, a higher chance of pathology. The diagnosis of ITP is a clinical one and is a diagnosis of exclusion. Low platelet count can be a feature of a large number of diseases and, when serious, warrants investigation by a hematologist. Secondary causes include leukemia, medications (e.g. quinine, heparin), lupus erythematosus and some other autoimmune disorders, cirrhosis (leading to thrombocytopenia from hypersplenism), HIV, congenital causes, and antiphospholipid syndrome. A bone marrow examination may be performed on patients over the age of 60 and people who do not respond to treatment, or when the diagnosis is in doubt. Despite the destruction of platelets by splenic macrophages, the spleen is normally not enlarged. In fact, an enlarged spleen should lead a clinician to investigate other possible causes for the thrombocytopenia. Accelerated formation of platelets results in the presence of abnormally large platelets which are seen in a peripheral blood smear. Overall bleeding time is prolonged in these patients, but prothrombin time (PT) and partial thromboplastin time (PTT) are normal (because the problem is with the platelets, not with the coagulation cascade). Occasionally, autoimmune hemolytic anemia and immune thrombocytic purpura may coexist, which is a condition called Evans syndrome. Treatment Mild ITP does not require treatment. When platelet counts fall under 10,000 per microliter, or under 50,000 when hemorrhage occurs (e.g. in the digestive tract or in a severe nosebleed) treatment is generally initiated with steroids. Intravenous immunoglobulin (IVIg) is used for life threatening cases. Later, so-called steroid-sparing agents (alternatively called DMARDs) may be used. When these strategies fail, splenectomy (removal of the spleen) is often undertaken, as platelets targeted for destruction will often meet their fate in the spleen. A relatively new strategy is treatment with anti-D, an agent used in mothers who have been sensitized to rhesus antigen by a Rh+ baby, but the patient must be Rh+. Immunosuppresants like mycophenolate mofetil and azathioprine are becoming more popular for their effectiveness. Rituximab has also been used with some success for some patients. Extreme cases (very rare, especially rare in children) may require vincristine, a chemotherapy agent, to stop the immune system from destroying platelets. Intravenous immunoglobulin, while sometimes effective although not all patients respond, is expensive and the improvement is temporary (generally lasting less than a month). However, in the case of a pre-splenectomy ITP patient with dangerously low platelet counts, and a poor response to other treatments, IVIg treatment can increase platelet counts, making the splenectomy operation less dangerous. Platelet transfusion is not normally recommended and is usually unsuccessful in raising a patient's platelet count. This is because the underlying autoimmune mechanism that destroyed the patient's platelets to begin with will also destroy donor platelets. An exception to this rule is when a patient is bleeding profusely, when transfusion of platelets can quickly form a platelet plug to stop bleeding.

Question: Does Idiopathic Thrombocytopenic Purpura or (ITP) affect people who want to join the armed forces? Hi i really want to join the royal marines but im only 13 and i have ITP and im not sure if i will fail the medical test with ITP so please can someone let me know

Answer: it could because its a blood disease n dangerous if you get cut,i have itp had it for 9 yrs.but if your only 13 yours might have been caused by a virus n you may not have it when you decide to go into the service.

Question: does anyone here have Idiopathic Thrombocytopenic Purpura? I have cronic itp and was wanting to hear from anyone else that has it and if it makes them tired, so on so forth

Answer: I found out I had it right after I turned 18. I had a bloody nose that lasted 2 1/2 hours and purple spots showed up on my face and in my mouth and throat. I went to the ear nose and throat Dr to get my nose cauterized and he sent me to the lab to get my blood tested. That's when we found out my platelet count was 5000. If you have it you know that normal is at LEAST 120,000. I was in the hospital for a week.They had to do a bone marrow test which was awful! I got pumped with platelets all week. After I got released I was put on prednisone for 2 months but had a relapse in Feb of the next year. I went in as an outpatient for a day to get platelets again and was put back on the prednisone fro another 4 months. I have been fine since(I'm 32). Was considered in remission 4 years after. I have a CBC done every year just to make sure and last month I was at a very safe 450,000. I remember it did make be pretty tired. My friends would get mad because I didnt feel like going out. They couldnt understand the whole thing. If you have anyother questions, let me know!

Question: Has Anyone Lost someone to Idiopathic Thrombocytopenic Purpura (ITP)? I am loosing someone to ITP..Not ITP exactly but my little cousin was diagnosed with ITP at 3 years old, but he's been getting really sick on and off for about 5 years now. My cousin is 12 years old and he is now in the hospital in PICU and he has been declared brain dead. The doctors say that the medicine that he was taking to keep his blood level stable caused him to get an infection in his brain, what they think is meningitis. I dont understand how this can happen. and me and my cousins are finding it so hard to cope with this. Has anyone ever lost someone to this? How did you cope and just learn to move on. He hasnt died yet because hes still on a repirator. He cant breath on his own and i know the parents are thinking about pulling the plug. How can this be? This is the hardest thing ive ever been through. If you have information on support groups please send em. I dont want to talk someone but i feel like im cryin out for help. I dont know wat to do n e more.

Answer: I feel sorry your family is going through this experience. Immune suppresion is one of the ways to treat ITP which on the other hand predisposes one to infections, meningitis can be fatal unfortunately, I have copied below the search results on yahoo for itp support groups, if I can help more, please write to me,

Question: ITP? Idiopathic thrombocytopenic purpura? can someone tell me as much info as they know.. i dont know aout it and my friend has it.. can it lead to death? hope not :S

Answer: Idiopathic thrombocytopenic purpura (ITP) is a bleeding disorder in which the blood does not clot as it should. The bleeding is due to a low number of platelets (PLATE-lets), blood cells that help the blood clot and stop bleeding. People with ITP often have purple bruises that appear on the skin. The bruises mean that bleeding has occurred in small blood vessels under the skin. ITP is largely an autoimmune disease. The decrease in platelets occurs because the immune system attacks and destroys the body's own platelets, for an unknown reason. Normally, your immune system helps your body fight off infections and diseases. But when the immune system mistakenly attacks some part of a person's own body, this is called an autoimmune disease. Because "idiopathic" means "of unknown cause," a better name for most cases of ITP is immune thrombocytopenic purpura. Have a look at the below website for more info.

Question: any cure for itp i.e.Idiopathic thrombocytopenic purpura?

Answer: Idiopathic (immunologic) thrombocytopenic purpura is a bleeding disorder caused by thrombocytopenia not associated with a systemic disease. Typically, it is chronic in adults but is usually acute and self-limited in children. Spleen size is normal. Diagnosis requires that other disorders be excluded through selective tests. Treatment includes corticosteroids, splenectomy, and, for life-threatening bleeding, platelet transfusions, and IV immune globulin.

Question: anybody knows the best cure for - ITP (idiopathic thrombocytopenic purpura)?

Answer: try the site below :-) http://www.annals.org/cgi/content/full/126/4/319

Question: ITP - Idiopathic thrombocytopenic purpura? My Son has just been diagnosed with this condition, has anyone else out there been diagnosed with this disorder and can you tell me more about it. Symptoms etc. I know it has to do with the blood platelets and that when they are low he will come out in bruising etc. Is there any other treatments that he can have rather than the infusions when the levels are low, Is there anything that can be done to prevent the levels going low such as diet or medications ? At present they have not been able to stabilise his blood platelets. When he was being discharged from hospital his levels were 103, a few days later they were 203, His levels are now at 150, with his levels to be checked again next week.

Answer: They aren't quite sure what triggers ITP, but they believe it is a sort of autoimmune disorder where the body attacks it's own platelets. It's also been linked to recent viral infections, at least with children. The immune system gets put on alert during the infection, and for whatever reason doesn't stand down afterward. Idiopathic means it's something he's acquired, as opposed to being born with which is congenital. Thrombocytes are the pieces of your blood that help clot, and in the case of ITP there are not enough of them. Purpura is a medical term refering to the bruises appearance, purple under the skin. Purpura is the latin word for a purple spot. In children, it will quite often disappear within about a year- about 80 percent of the time or more. It isn't usually life threatening, but the nosebleeds and bruises can make it quite frightening. Since it involves a problem with the immune system, it's not really treatable with diet. Corticosteroids, such as prednisone, are commonly used to treat ITP. Those are safe to take, even if you had to take them for years by the way. They are not the same as the steroids you hear about with sports and body-building. They can also use injections of immune globulin and anti-Rh globulin. I recall reading of two other medications recently developed to use when the immune glubulin doesn't help, but I'm sorry to say I can't remember what they were called. However, the doctors will most certainly know I am sure. If all else fails, the other thing they will do is remove his spleen. That particular organ is about the size of a golf ball in children, and slightly above his stomach on the left side. It produces antibodies to fight infections, and those will sometimes go overboard and attack the platelets. In that case, removing the spleen will often cause the count to go back to normal levels. That particular surgery isn't done unless all else is failing and they have pretty much eliminated the other things. I've never seen it done with a child, only adults. The first choice of treatment is monitoring a child to keep tabs on the count. The next choice is to try medications and immune globulin injections. Transfusions of platelets is done only if bleeding gets severe or the level drops too low. In most cases, children will stabilize and improve gradually in the passing months. There will be some limitations on his activites which may prove frustrating to him, depending on how old he is and what he likes to do. Contact sports will be out of the question, obviously. So will things like horseback riding where you can fall. The greatest worry would be in the case of a head injury, where bleeding would be hard to detect at first and could be nasty. I imagine he would be allowed to ride a bike and skate, but he'd definitely need to wear a helmet and pads. You need to ask his doctor for guidance on that. Keep bags of tiny frozen peas on hand, so bumps and such can be chilled quickly to prevent the worst of the bruising. Those conform to body parts a lot easier than the old ice packs do. Frozen niblet corn works well too in a pinch. I wish you well, and hopefully his levels will stabilize soon.

Question: anyone else have Idiopathic Thrombocytopenic Purpura n been through this? i had a bone marrow test on my right hip 2001 to confirm i had ITP my dr told me that i would have pain for a week but after 9 yrs i still have it i went back to the dr after 2 weeks n he said there was nothing wrong.after complaining for yrs to different drs i found one that would listen.this doctor did test n said the sciatic nerve was damaged during the bone marrow test.it gets worse every year they thought about deadening the nerve but it would be to dangerous since i have the blood clotting problem.i wanna know if anyone else has itp n had a bone marrow test done n your hip was never right again?

Answer: I have ITP, but I have never had a bone marrow test. I have checked out this website and found some helpful info. http://www.pdsa.org/ If you would like to chat, feel free to email me.

Question: Does anyone knows how effective it is to be treated with Rituximav if I've got ITP? Idiopathic Thrombocytopenic Purpura

Answer: Why are doctors suggesting rituximab? Rituximab is an antibody against the CD20 marker on B-cells. There is some evidence that it works but usually the first line of treatment is a corticosteroid such as prednisone.

Question: idiopathic thrombocytopenic purpura costs? for a school research project im making a power point presenatation about ITP (idiopathic thrombocytopenic purpura ) and i need to know how much it costs to get treatments etc.i looked it up and couldn't find it. please help me!!! and don't post if you aren't sure its right. thankssss!

Answer: Well, why don't you look up prednisone and see how much that costs because that is the treatment, if treatment is even needed. Sometimes it is very mild. On the other hand sometimes the prednisone doesn't help and they have to take the spleen out so look up how much it cost to remove a spleen. THERE, that would be how to find your answer! So in one person, it might me $0 and another might have to have the operation which could be $2000! So it all depends on how much treatment is needed. How is ITP treated in children? Because most children recover with no treatment, many doctors recommend just watching them carefully and taking care of the bleeding symptoms. Children don't have to go to the hospital if good care is available at home. However, some doctors recommend a short treatment with prednisone pills or intravenous infusions (given in a vein) of gamma globulin to increase the platelet count more quickly. Both medicines have some side effects. How does ITP affect adults? In most adults, ITP lasts much longer than it does in children. At the time of diagnosis, most adults have noticed increased bleeding and easy bruising for several weeks, or even months. In women, increased menstrual blood flow is a major sign. Many adults have only mild thrombocytopenia. In fact, quite a few people have no bleeding symptoms. They are only diagnosed with ITP when their blood is checked for another reason and a low blood platelet count is found. Return to top How is ITP treated in adults? Treatment of ITP in adults is aimed at increasing the blood platelet count. This is not the same as curing the disease. Patients may take prednisone for several weeks, even a month or longer. However, when the medicine is stopped, the platelet counts may get low again. If prednisone doesn't help enough, the spleen can be removed. The spleen makes most of the antibodies that destroy the blood platelets. It also destroys old or damaged blood cells. In an otherwise healthy young person, removal of the spleen is not a serious operation. http://familydoctor.org/online/famdocen/…

Question: Anyone with ITP? What has been your experience with Idiopathic Thrombocytopenic Purpura? I have a friend who was hospitalized with it last year. She had a lot of complications and had her spleen removed, but is now fine. They have no idea what caused it. What are the chances of her having problems with ITP later in life?

Answer: I have not had this, but do know some who do or have had it. Has she been tested for antiphospholipid syndrome?. Though this is a clotting disorder, some with it do have ITP. I am including a couple of links for you. http://www.hughes-syndrome.org/snapshot.… http://mayoclinic.com/health/antiphospho…

Question: Question About ITP [Long]? Hi. I need serious answers to this only, please. I've tried Google and can't find anything. I have a blood disorder called Idiopathic Thrombocytopenic Pupura (ITP, for short). http://en.wikipedia.org/wiki/Idiopathic_… I was diagnosed in Jan. 2006. We've tried numerous treatments including Retuxan, IVIG, Gamunex, Windrow, and a few others. Most of these (at least one) would have worked for the typical ITP patient. I am a 14 year old girl and something crossed my mind. Could this be something else, disguised as ITP? I also have Anemia, which is now under control. I get frequent migranes. Has anyone ever heard of anything else sounding similar to this? Thanks so much.

Answer: yes it is this is answered very well at http://www.cidpusa.org read story number 22 about ITP and full recovery

Question: am i able to do this?? i have a blood disease called Idiopathic thrombocytopenic purpura also known as ITP and the last time i had my blood test was about 2 weeks ago and my blood platelets were 20, am i allowed to drink in small quantity?

Answer: Alcohol thins your blood and will take longer to clot. You already have a severe clotting platelet count. I wouldn't risk it unless you are bedridden with absolutely NO chance of bumping into anything or injurying yourself...I KNOW your doctor told you this so please don't think laymen have anything to contribute to the contrary.

Question: Questions about Lymphoma ..? My Fiance is in the process of being diagnosed with some sort of Lymphoma. The diagnosis is being made after inital investigations of Idiopathic thrombocytopenic purpura (low platlet count). My question is: all his blood work is fine besides the low platlets levels. Should his red and white blood cells be normal, which they are, could it be a minor form of Lymphoma?? Is all Lymphoma a type of Cancer? I know this isn't a place to search for a diagnosis. My Fiance is having a biopsy on the lymph glands next Monday. I am just scared and upset and am trying to understand the information given to me. Thanks so much.

Answer: There a few different types. It's hard to say what kind until it is formally diagnosed. Try checking out The American Cancer Society web page. They have lots of info on all the different types. I know it's a super scary thing to deal with. When my husband was 23 he was diagnosed with Synovial Sarcoma. He had a large tumor on the back of his neck. It was a super hard process for our young family (we have 3 children) both physically and emotionally. Now he's 34 and cancer free! The best thing you can do for both you and your fiance is to get into some sort of support group. It makes it a lot easier to deal with your emotions if you can share them with someone going through the same thing. Remember there are so many options to combat this sort of thing and prognosis is generally a lot better now a days as compared to even 20 years ago. It's definitely ok to feel scared and don't let anyone tell you otherwise. Keep your chin up and best of wishes to you guys!

Question: Is there anyone else out there with ITP? Hi to all, Im just wondering if there is anyone else (i know there are some) with idiopathic thrombocytopenic purpura. I know all about the condition and things like that, i would just like to hear from someone who has it and how they have coped? Any medications they have found successful? What there average count is? What has not worked? How they are feeling? Just things in general that may help me or i could perhaps hand on information? So out of all of the apparent millions of people here on YA no one has ITP, i think my doc lied about the statistics.?

Answer: My wife had it years ago. Fortunately, prednisone did the trick. I think her count dropped in to the 60's before rebounding. Extensive bruising, episode of "minor" joint bleeding,. It took several months before she was up to par. Good luck.