Immune Thrombocytopenic Purpura Patient & Family Handbook

WHAT IS ITP? ITP stands for immune thrombocytopenic purpura. ITP occurs when the body’s immune system does not work correctly and results in thrombocytopenia , a decrease in the number of platelets. Platelets are cells in our blood that help form clots to prevent or stop bleeding. When the platelet count is low, the risk of bruising and bleeding increases. One may also develop tiny blood spots under the skin or inside the mouth (petechiae). A normal platelet count is between 150,000 and 400,000. In children with ITP, the plate - let count is less than 100,000. Bleeding after

a minor injury may occur when the platelet count is less than 50,000. The most serious risk of bleeding occurs when the platelet count is less than 20,000. When the count is this low, bleeding may occur without any injury. The cause of ITP is not always known, but it often occurs after a viral illness or infection. It can also be associated with some medications and with autoimmune disorders such as lupus. To fight infections, white blood cells make special proteins called antibodies . These antibodies attach to infection-causing agents such as bacteria and viruses that have invaded the body. Anything the antibody attaches to is seen as foreign by the body. The spleen is an organ that filters the antibody-coated viruses or bacteria out of the blood. In ITP, these same antibodies attach themselves to healthy platelets. The antibodies tell the body that these platelets are foreign and the spleen destroys them. As long as antibodies are attached to the platelets, the spleen will continue to remove as many platelets as possible from the body, resulting in a decreased number of platelets in the blood. Platelets are made in the bone marrow by large cells called megakaryocytes. Thrombopoietin, a protein made by the liver, controls how many platelets are made by the megakaryocytes. In some cases of ITP, not enough throm - bopoietin reaches the bone marrow. When this happens, the megakaryocytes do not make enough new platelets to replace those being destroyed. Most cases of ITP are temporary, or acute . More than 80% of ITP cases in children go away in fewer than 6 months. This happens when the body stops making antibodies against the platelets. Depending on the number of platelets and the risk for serious bleeding, your provider may recommend medications to help manage ITP. If ITP lasts more than 6–12 months it is called chronic . Chronic ITP may also need to be managed with medications or just observed to make sure that no serious bleeds occur.

WHO GETS ITP? ITP can occur in children and adults. Newborns can develop ITP shortly after birth if the child’s mother had ITP during pregnancy. Children are more likely to have acute ITP, while teenagers are more likely to have chronic ITP. Boys and girls are affected equally. ITP is not contagious; it cannot be passed from one person to another. ITP is not inherited.

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