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Iris Valera Larios on ITP blood disorder treatments : What are platelets? There are three types of blood cell which are all formed in the bone marrow; red cells, white cells and platelets. Platelets, which are small and sticky and circulate in the bloodstream provide the inital plug to stop bruising and bleeding after an injury, and stop blood leaking from capilleries. A blood sample is taken to measure the circulating platelets, and in most people there are between 150,000 and 400,000 platelets in every cubic millimetre of blood. However in the USA we simplify this by describing a platelet count of, say, 150 rather than 150,000. Anyone with a count less than 100 would be considered thrombocytopenic (ie. short of platelets).
What is ITP? Immune thrombocytopenia (formerly known as idiopathic thrombocytopenic purpura) is a medical term for an autoimmune disorder (immune) causing a shortage of platelets (thrombocytopenia) and bruising (purpura). What is the cause of ITP? ITP is an autoimmune disease in which the immune system mistakes the platelets as being foreign and destroys them. It can follow a virus, vaccination or certain medications, but for most people the cause is unknown.
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First line treatment is typically with tablet steroids such as prednisolone. About 70-80% of individuals will respond to steroids and initial treatment will usually be for 6-8 weeks, although the dose will be reduced during that time, rather than stopped suddenly. Steroids can have side effects. You may not have side effects but these can include gastric irritation (we may recommend an additional tablet to protect the lining of the stomach), mood or sleep disruption, greater risk of infection, fluid retention, increased appetite, increased blood sugar or blood pressure, muscle weakness and thinning of the bones. For some individuals, we may also recommend additional treatment to protect the bones while on steroids.
Careful review of your medications: Historically, a bone marrow aspiration was required to make a diagnosis of ITP. It may not be absolutely necessary in the face of a positive antiplatelet antibody test, but it is still commonly done to look at the production of platelets and to rule out any abnormal cells the marrow may be producing that could lower platelet counts. A bone marrow aspiration is necessary for a diagnosis if the antiplatelet antibody testing is negative. Find even more information on Iris Valera-Larios.
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What are the symptoms of idiopathic thrombocytopenic purpura? Normal platelet count is in the range of 150,000 to 450,000. With ITP, the platelet count is less than 100,000. By the time significant bleeding occurs, you may have a platelet count of less than 10,000. The lower the platelet count, the greater the risk of bleeding. Because platelets help stop bleeding, the symptoms of ITP are related to increased bleeding. However, each person may experience symptoms differently.