Idiopathic Thrombocytopenic Purpura(ITP) medical name of purpura is a disorder that causes excess of bleeding. The cells that help in blood clotting would be low in such people. ITP can develop both in adults and children. ITP develops after viral infection in children and in some adults it can be chronic (long term). Your doctor will monitor the symptoms carefully and give treatment when the blood platelet count is very low.
ITP causes pink color spots on the skin mostly on your legs. These spots form as a result of internal bleeding of blood vessels under the skin. Purpura of very small size is called petechiae and larger ones are known as ecchymoses. Purpura may develop either due to normal platelet counts known as non thrombocytopenic and due to decrease in platelet count called as thrombocytopenic purpuras.
Symptoms :
Purpura(ITP) is characterized by the formation of small pink colored spots on the skin. The blood vessel under the skin would bleed causing rashes or reddish pink spots on the skin. It can occur anywhere in the body but mostly found in lower legs and face. Your skin is more prone to bleed even for small injuries. There would be prolonged bleeding when you have accidental injury or cuts. It can also cause spontaneous bleeding from your nose.
Some people affected with ITP would have bleeding of gums that would not stop after dental procedures. It can cause heavy bleeding during menstrual cycles in women and bloody urine and stools in men. If there is any abnormal bleeding along with pink spots on the skin, you need to consult your doctor.
Causes :
What exactly causes purpua is not known and hence it is known as “idiopathic” meaning unknown. It is believed to be caused by weakened immunity or abnormal functioning of immune system wherein it attacks the blood platelets that is responsible for clotting of blood. Antibodies of immune system would get attached to the blood platelets which are eventually attacked and destroyed by the Spleen. This result in reduced number of platelets causing excessive bleeding or bruising.
People with purpura will have platelet count as low as 20,000 or even below. Normal platelet count for healthy person would be 150,000 or more. When the platelet counts gets very low (below 15,000 or 10,000) per microlitre it can cause internal bleeding. Children can develop ITP after viral infection like Mumps or Measles. Non thrombocytopenic purpura can be caused be hereditary or congenital or it can be caused due to connective tissue disorders or severe effects of drugs like steroids.
Complications :
In severe cases, ITP can cause serious internal bleeding in the vital organs like brain or heart. Complications can occur due to long-term usage of corticosteroids that can cause Osteoporosis, increased blood sugar levels and cataracts. In rare cases pregnant women with ITP can pass on the low platelet count to the fetus causing severe complications.
Diagnosis :
Your doctor will look for the above symptoms of pinkish spots and easy bleeding. He may order for series of tests including blood profile, blood smear and bone marrow test. Reduced platelet count in the blood is indicative of purpura disorder. Biopsy of bone marrow tissue is done and tested in the lab for confirming the diagnosis.
Treatment :
The aim of giving treatment is to increase the platelet count to prevent any complications. Recovery from ITP depends on your age and health condition. Children with purpura can recover fully within short period. Mild form of ITP in adults needs no treatment except monitoring the platelet count regularly. However your doctor would start treatment if the symptoms become worse and you often develop bruising and bleeding.
Adults with this disorder should avoid taking drugs like ibuprofen, aspirin and blood thinning drugs like warfarin which can further reduce platelet count. Corticosteroid like prednisone is given for increasing the platelet count. Most of the people will show improvement within 4-6 weeks of starting treatment. Your doctor will taper the medication and gradually stop them, after your platelet level is back to normal. Corticosteroid can cause adverse effects like weight gain, blood sugar (diabetes), cataracts and osteoporosis.
For more severe cases, intravenous immune globulin is injected to stop critical bleeding. It can cause mild side effects like Headache and nausea. Nowadays doctors use thrombopoietin receptor agonists like romiplostim or promacta for treating ITP. These medications increase the platelet count thereby reducing bleeding and bruising. Rituximab is another option of treating purpura to suppress the immune system.
In severe cases or critical bleeding, spleen has to be removed by surgery. Splenectomy is to be done to increase the platelet count. But it is a rare choice of treatment for ITP. Severe internal bleeding can occur in rare cases which can be fatal or life threatening. In such cases, emergency treatment is given for the patient by making platelet transfusion intravenously.
Pictures of Purpura :
Images, Pics, Pictures and Photos of Purpura
Lifestyle Changes :
People with ITP should avoid taking Advil or Motrin IB or aspirin and other pain killers which can cause further complications. They should not indulge in sports or any other activities that can cause bruises or injury.
