Immune Thrombocytopenia: Symptoms, Causes & Treatment

Immune thrombocytopenia (immune thrombocytopenic purpura) is a disorder in which the platelet count in the blood drops due to an immune disturbance. Platelets are small cells responsible for blood clotting and stopping bleeding; in this condition the immune system mistakenly forms antibodies that attack platelets and destroy them in the spleen, and may also suppress their production in the bone marrow.

As a result of low platelets, the tendency to bleed and bruise increases. Symptoms include easy bruising, small red or purple bleeding spots on the skin (petechiae), bleeding from the gums or nose, heavy menstruation, and in severe cases (which are less common) internal bleeding may occur. The disease differs between an acute type that usually affects children after a viral infection and resolves on its own in most cases, and a chronic type more common in adults.

Managing immune thrombocytopenia depends on the severity of the deficiency and bleeding risk, not on the number alone. In mild cases without bleeding, monitoring and follow-up suffice, as many children recover on their own. With a severe platelet drop or bleeding, treatment is started to raise platelets, including drugs that suppress the immune response (such as corticosteroids) or other medications, and sometimes splenectomy in selected resistant cases. Correct diagnosis is important by ruling out other causes of low platelets, avoiding drugs that increase bleeding such as aspirin, and seeing the doctor for any worrying bleeding.

• Easy bruising and small bleeding spots on the skin (petechiae).
• Gum and nose bleeding.
• Heavy menstruation.
• In severe cases: internal bleeding (less common).

• An immune disturbance forming antibodies that attack and destroy platelets.
• It may follow a viral infection, especially in children.
• Often without a clear cause in the chronic type in adults.

• Complete blood count showing low platelets with the rest of the cells usually normal.
• Blood smear and ruling out other causes of low platelets.
• Bone-marrow examination in selected cases.

Monitoring

• Follow-up without treatment in mild cases without bleeding, especially in children.

Treatment when needed

• Immune-suppressing drugs (such as corticosteroids) or immunoglobulin to raise platelets quickly.
• Platelet-stimulating drugs or splenectomy in chronic resistant cases.

Avoid drugs that increase bleeding such as aspirin. This content is educational and does not replace consulting a hematologist.

• Severe bleeding with a marked platelet drop.
• Serious internal bleeding (rare) such as brain hemorrhage.
• Side effects of immune-suppressing treatment that are managed medically.

• There is no prevention of the disease itself.
• Avoiding drugs and activities that increase bleeding risk when platelets are low.
• Regular monitoring of the platelet count.