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Immune Thrombocytopenia (ITP)

Immune thrombocytopenia (ITP) is a bleeding disorder. In ITP, the blood doesn't clot as it should. This is due to a low number of blood cell fragments called platelets or thrombocytes.

PubMed Health Glossary
(Source: NIH - National Heart, Lung, and Blood Institute)

Immune Thrombocytopenia

Immune thrombocytopenia (THROM-bo-si-toe-PE-ne-ah), or ITP, is a bleeding disorder. In ITP, the blood doesn't clot as it should. This is due to a low number of blood cell fragments called platelets (PLATE-lets) or thrombocytes (THROM-bo-sites).

Platelets are made in your bone marrow along with other kinds of blood cells. They stick together (clot) to seal small cuts or breaks on blood vessel walls and stop bleeding.

Overview

Without enough platelets, bleeding can occur inside the body (internal bleeding) or underneath or from the skin (external bleeding).

People who have ITP often have purple bruises called purpura (PURR-purr-ah). These bruises appear on the skin or mucous membranes (for example, in the mouth). Bleeding from small blood vessels under the skin causes purpura.

People who have ITP also may have bleeding that causes tiny red or purple dots on the skin. These pinpoint-sized dots are called petechiae (peh-TEE-kee-ay). Petechiae may look like a rash....Read more about Immune Thrombocytopenia
NIH - National Heart, Lung, and Blood Institute

What works? Research summarized

Evidence reviews

Drug therapy for treating idiopathic thrombocytopenic purpura during pregnancy

Idiopathic thrombocytopenic purpura (ITP) is an immune‐mediated hematologic disorder caused by a low blood platelet count (thrombocytopenia). Antiplatelet antibodies act against the platelets resulting in platelet destruction by the spleen. In adults, the clinical features of ITP often have an insidious onset and are highly variable, ranging from no symptoms, mild bruising, to mucosal bleeding, and skin discolorations. Management of ITP during pregnancy is complex because of large differences between maternal and fetal platelet counts. The circulating antibodies can cross the placenta and cause a neonatal passive immune thrombocytopenia that may increase the risk of cerebral haemorrhage in the newborn infant. For this reason, it seems reasonable that cesarean section delivery is safer for the infant than vaginal delivery yet the mode of delivery may not affect the rate of haemorrhage. Many different pharmacological interventions are used for treating this medical disorder and treatment for ITP in pregnant women is not standardised. Some of these drugs have potential side effects for pregnant women and some can cause fetal malformation.

TPO receptor agonists for treating chronic idiopathic thrombocytopenic purpura

Chronic idiopathic thrombocytopenic purpura (ITP) is an acquired autoimmune disorder characterized by low platelet counts. To date, the therapies that primarily aim to reduce platelet destruction, such as corticosteroids, intravenous immunoglobulins and splenectomy, have been the mainstay of treatment in ITP. However, TPO receptor agonists such as romiplostim and eltrombopag, which aim to enhance platelet production, are novel drugs that have been suggested to be more effective. This review included six trials with 808 patients and compared TPO receptor agonists with placebo or standard of care (SOC).

Effectiveness and safety of middle and low-dose gamma globulin for severe idiopathic thrombocytopenic purpura: a systematic review

Bibliographic details: Li Z, Yilidaer A, Zhang ZG, Halida Y.  Effectiveness and safety of middle and low-dose gamma globulin for severe idiopathic thrombocytopenic purpura: a systematic review. Chinese Journal of Evidence-Based Medicine 2014; 14(3): 312-319 Available from: www.cjebm.org.cn/oa/DArticle.aspx?type=view&id=20140303

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Summaries for consumers

Drug therapy for treating idiopathic thrombocytopenic purpura during pregnancy

Idiopathic thrombocytopenic purpura (ITP) is an immune‐mediated hematologic disorder caused by a low blood platelet count (thrombocytopenia). Antiplatelet antibodies act against the platelets resulting in platelet destruction by the spleen. In adults, the clinical features of ITP often have an insidious onset and are highly variable, ranging from no symptoms, mild bruising, to mucosal bleeding, and skin discolorations. Management of ITP during pregnancy is complex because of large differences between maternal and fetal platelet counts. The circulating antibodies can cross the placenta and cause a neonatal passive immune thrombocytopenia that may increase the risk of cerebral haemorrhage in the newborn infant. For this reason, it seems reasonable that cesarean section delivery is safer for the infant than vaginal delivery yet the mode of delivery may not affect the rate of haemorrhage. Many different pharmacological interventions are used for treating this medical disorder and treatment for ITP in pregnant women is not standardised. Some of these drugs have potential side effects for pregnant women and some can cause fetal malformation.

TPO receptor agonists for treating chronic idiopathic thrombocytopenic purpura

Chronic idiopathic thrombocytopenic purpura (ITP) is an acquired autoimmune disorder characterized by low platelet counts. To date, the therapies that primarily aim to reduce platelet destruction, such as corticosteroids, intravenous immunoglobulins and splenectomy, have been the mainstay of treatment in ITP. However, TPO receptor agonists such as romiplostim and eltrombopag, which aim to enhance platelet production, are novel drugs that have been suggested to be more effective. This review included six trials with 808 patients and compared TPO receptor agonists with placebo or standard of care (SOC).

Unfractionated heparin versus low molecular weight heparin for avoiding heparin‐induced thrombocytopenia in postoperative patients

Heparin is a natural agent used to prevent clot formation in the vessels. Two types of heparins are widely used, unfractionated heparin (UFH) and low molecular weight heparin (LMWH). Heparin‐induced thrombocytopenia (HIT) is an adverse reaction that can occur during treatment with heparin. It is common in practice and its most important consequence is a paradoxical increase in the risk of clotting (thromboembolic) complications. A number of factors are thought to influence its frequency, including the type of heparin and the type of patient, with patients who have had a surgery at higher risk. We compared the risk of HIT in people who had had surgery and had been exposed to UFH or LMWH. A better understanding of this problem will allow safer management of postoperative patients who need thromboprophylaxis with heparin.

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Terms to know

Autoimmune Disease
Disease that results when the immune system mistakenly attacks the body's own tissues. Examples include multiple sclerosis, type 1 diabetes, rheumatoid arthritis, and systemic lupus erythematosus.
Blood Plasma
The clear, yellowish, fluid part of the blood that carries the blood cells. The proteins that form blood clots are in plasma.
Bone Marrow
The soft, sponge-like tissue in the center of most bones. It produces white blood cells, red blood cells, and platelets.
Idiopathic
A medical term meaning "of unknown cause".
Macrophages
A type of white blood cell that surrounds and kills microorganisms, removes dead cells, and stimulates the action of other immune system cells.
Petechiae
Pinpoint, unraised, round red spots under the skin caused by bleeding.
Platelets (Thrombocytes)
A tiny piece of cell that is made by breaking off of a large cell in the bone marrow. Platelets are found in the blood and spleen. They help form blood clots to slow or stop bleeding, and to help wounds heal. Also called thrombocyte.

More about Immune Thrombocytopenia

Photo of an adult

Also called: Immune thrombocytopaenia, Immune thrombocytopenic purpura, Autoimmune thrombocytopenic purpura

See Also: Thrombocytopenia

Other terms to know: See all 7
Autoimmune Disease, Blood Plasma, Bone Marrow

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