Immune Thrombocytopenic Purpura

Immune thrombocytopenic purpura, (ITP) is an autoimmune bleeding disorder. The immune system destroys platelets, which are necessary for normal blood clotting. Persons with the disease have too few platelets in the blood.  ITP is sometimes called immune thrombocytopenic purpura or simply, immune thrombocytopenia. ITP occurs when certain immune system cells produce antibodies against platelets. Platelets help your blood clot by clumping together to plug small holes in damaged blood vessels. The antibodies attach to the platelets. The spleen destroys the platelets that carry the antibodies.

In children, the disease sometimes follows a viral infection. In adults, it is more often a chronic (long-term) disease and can occur after a viral infection, with use of certain drugs, during pregnancy, or as part of an immune disorder.

ITP affects women more often than men, and is more common in children than adults. The disease affects boys and girls equally. Symptoms can include any of the following: abnormally heavy menstruation, bleeding into the skin, often around the shins, causing a skin rash that looks like pinpoint red spots (petechial rash), easy bruising, nosebleed or bleeding in the mouth.

Types of TTP:

TTP comes in two main types:

  1. Acquired TTP: This is the more common type, where your immune system mistakenly destroys your platelets.
  2. Hereditary TTP: A rare genetic condition that affects the production of a protein necessary for blood clotting.

Causes of TTP 

  1. Autoimmune Disorders: When your immune system attacks your own platelets.
  2. Medications: Some drugs can trigger TTP as a side effect.
  3. Pregnancy: TTP can develop during pregnancy or shortly after childbirth.
  4. Infections: Certain infections can lead to TTP.
  5. Cancer: In some cases, cancer can cause TTP.
  6. Chemotherapy: Cancer treatments may increase the risk of TTP.
  7. Bone Marrow Disorders: Issues with the bone marrow can affect platelet production.
  8. Genetic Mutations: Inherited genetic mutations can cause hereditary TTP.
  9. HIV/AIDS: People with HIV/AIDS are at a higher risk.
  10. Inflammatory Disorders: Conditions like lupus can trigger TTP.
  11. Blood Transfusions: Rarely, TTP can occur after receiving blood products.
  12. Certain Antibiotics: Some antibiotics can lead to TTP.
  13. Kidney Disorders: Kidney problems may contribute to TTP.
  14. Pregnancy Complications: High blood pressure during pregnancy can lead to TTP.
  15. Chemical Exposures: Exposure to certain chemicals may increase the risk.
  16. Bone Marrow Transplants: In rare cases, TTP can develop post-transplant.
  17. Idiopathic: In some cases, the cause remains unknown.
  18. Alcohol Abuse: Excessive alcohol consumption can contribute.
  19. Hormone Replacement Therapy: TTP has been associated with HRT.
  20. Trauma: Severe injuries may lead to TTP in rare instances.

Symptoms of TTP 

  1. Easy Bruising: You may bruise easily even with minor bumps.
  2. Petechiae: Tiny red or purple dots on the skin.
  3. Fatigue: Feeling excessively tired is common.
  4. Jaundice: Yellowing of the skin and eyes due to anemia.
  5. Fever: Sometimes, TTP is accompanied by a fever.
  6. Headaches: Frequent and severe headaches are possible.
  7. Confusion: Changes in mental clarity can occur.
  8. Shortness of Breath: Due to decreased oxygen-carrying capacity.
  9. Chest Pain: Chest discomfort may be present.
  10. Dark Urine: Urine may appear dark or bloody.
  11. Abdominal Pain: Discomfort or pain in the abdomen.
  12. Nausea and Vomiting: Digestive symptoms can occur.
  13. Bleeding Gums: Gums may bleed easily.
  14. Nosebleeds: Frequent nosebleeds can be a sign.
  15. Hematuria: Blood in the urine may be present.
  16. Swollen Lymph Nodes: Lymph nodes may become enlarged.
  17. Muscle Weakness: Due to anemia and low platelets.
  18. Vision Changes: Blurred vision or visual disturbances.
  19. Difficulty Speaking: Speech problems are possible.
  20. Paralysis: Severe cases may lead to paralysis.

Diagnostic Tests for TTP

  1. Complete Blood Count (CBC): Measures platelet levels.
  2. Blood Smear: Examines blood under a microscope for platelet abnormalities.
  3. Peripheral Blood Smear: Checks for unusual blood cell shapes.
  4. Hemoglobin and Hematocrit Tests: Assess for anemia.
  5. Bilirubin Test: Measures the presence of jaundice.
  6. LDH (Lactate Dehydrogenase) Test: Elevated levels can indicate TTP.
  7. Kidney Function Tests: To check for kidney involvement.
  8. Coagulation Panel: Evaluates blood clotting factors.
  9. ADAMTS13 Activity Test: Measures the activity of a specific enzyme.
  10. Bone Marrow Biopsy: May be needed to assess bone marrow health.
  11. Chest X-ray: To rule out other conditions.
  12. CT Scan: Provides detailed images of internal organs.
  13. MRI: Useful for brain and nervous system evaluation.
  14. Electrocardiogram (ECG or EKG): Checks heart function.
  15. Ultrasound: Can assess blood flow and organs.
  16. Liver Function Tests: Evaluate liver health.
  17. Stool Guaiac Test: Detects blood in stool.
  18. Arteriogram: May be needed for severe cases.
  19. Spinal Tap (Lumbar Puncture): To rule out nervous system involvement.
  20. Genetic Testing: For hereditary TTP diagnosis.

Treatments for TTP 

  1. Plasma Exchange (Plasmapheresis): Removes antibodies causing TTP.
  2. Corticosteroids: Suppress the immune response.
  3. Immune Globulin (IVIG): Provides antibodies to replace damaged ones.
  4. Rituximab: Targets specific immune cells.
  5. Splenectomy: Surgical removal of the spleen in severe cases.
  6. Platelet Transfusions: Temporary relief for low platelet counts.
  7. Red Blood Cell Transfusions: To treat anemia.
  8. Medications to Suppress the Immune System: Such as cyclophosphamide.
  9. Kidney Dialysis: If kidney function is severely affected.
  10. Pain Management: Medications for headaches and body pain.
  11. Anti-Seizure Medications: For neurological symptoms.
  12. Intravenous Fluids: To maintain hydration.
  13. Antibiotics: If infections are present.
  14. Supportive Care: Monitoring vital signs and symptoms.
  15. Counseling: For emotional support and coping strategies.
  16. Physical Therapy: To address weakness and mobility issues.
  17. Occupational Therapy: Helps with daily tasks.
  18. Speech Therapy: If speech or swallowing is affected.
  19. Nutritional Support: Ensures adequate nutrition.
  20. Avoiding Triggers: Identifying and avoiding TTP triggers.
  21. Pregnancy Management: Special care during pregnancy.
  22. Genetic Counseling: For hereditary TTP.
  23. Pain Relief Measures: Warm compresses and pain relievers.
  24. Blood Pressure Control: For those with hypertension.
  25. Smoking Cessation: Smoking can worsen TTP.
  26. Alcohol Moderation: Reducing alcohol intake.
  27. Stress Reduction Techniques: To manage stress.
  28. Hygiene Practices: To prevent infections.
  29. Regular Follow-up: With healthcare providers.
  30. Patient Education: Understanding the condition and its management.

Common Drugs for TTP

  1. Corticosteroids: Examples include prednisone.
  2. Rituximab: A monoclonal antibody medication.
  3. Plasma Products: To replace deficient proteins.
  4. Cyclophosphamide: An immunosuppressive drug.
  5. IVIG (Intravenous Immunoglobulin): Contains antibodies.
  6. ADAMTS13 Enzyme Replacement: In some cases.
  7. Antibiotics: For treating infections.
  8. Pain Relievers: Such as acetaminophen.
  9. Anti-Seizure Medications: For neurological symptoms.
  10. Anti-Hypertensive Drugs: To control blood pressure.
  11. Hormone Replacement Therapy: In specific cases.
  12. Folate Supplements: To support red blood cell production.
  13. Antiplatelet Medications: In certain situations.
  14. Diuretics: For managing fluid balance.
  15. Immunosuppressants: Such as azathioprine.
  16. Anticoagulants: Rarely used due to bleeding risk.
  17. Vitamin B12 Supplements: To address anemia.
  18. Calcium Channel Blockers: If hypertension is present.
  19. Anti-Inflammatory Drugs: For pain and inflammation.
  20. Antidepressants: For mood management if needed.

In Conclusion:

Thrombocytopenic Purpura (TTP) is a complex condition, but understanding its types, causes, symptoms, diagnostic tests, treatments, and common drugs can help you navigate it more easily. If you suspect TTP or have been diagnosed, consult a healthcare professional for personalized guidance and care. Early detection and appropriate management can make a significant difference in managing TTP effectively.

 

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. Thank you for giving your valuable time to read the article.

  1. https://medlineplus.gov/skinconditions.html
  2. https://www.aad.org/about/burden-of-skin-disease
  3. https://www.usa.gov/federal-agencies/national-institute-of-arthritis-musculoskeletal-and-skin-diseases
  4. https://www.cdc.gov/niosh/topics/skin/default.html
  5. https://www.skincancer.org/
  6. https://illnesshacker.com/
  7. https://endinglines.com/
  8. https://www.jaad.org/
  9. https://www.psoriasis.org/about-psoriasis/
  10. https://books.google.com/books?
  11. https://www.niams.nih.gov/health-topics/skin-diseases
  12. https://cms.centerwatch.com/directories/1067-fda-approved-drugs/topic/292-skin-infections-disorders
  13. https://www.fda.gov/files/drugs/published/Acute-Bacterial-Skin-and-Skin-Structure-Infections—Developing-Drugs-for-Treatment.pdf
  14. https://dermnetnz.org/topics
  15. https://www.aaaai.org/conditions-treatments/allergies/skin-allergy
  16. https://www.sciencedirect.com/topics/medicine-and-dentistry/occupational-skin-disease
  17. https://aafa.org/allergies/allergy-symptoms/skin-allergies/
  18. https://www.nibib.nih.gov/
  19. https://rxharun.com/rxharun/rxharun/article-types/skin-care-beauty/skin-diseases-types-symptoms-treatment/
  20. https://www.nei.nih.gov/
  21. https://en.wikipedia.org/wiki/List_of_skin_conditions
  22. https://en.wikipedia.org/?title=List_of_skin_diseases&redirect=no
  23. https://en.wikipedia.org/wiki/Skin_condition
  24. https://oxfordtreatment.com/
  25. https://www.nidcd.nih.gov/health/
  26. https://consumer.ftc.gov/articles/w
  27. https://www.nccih.nih.gov/health
  28. https://catalog.ninds.nih.gov/
  29. https://www.aarda.org/diseaselist/
  30. https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets
  31. https://www.nibib.nih.gov/
  32. https://www.nia.nih.gov/health/topics
  33. https://www.nichd.nih.gov/
  34. https://www.nimh.nih.gov/health/topics
  35. https://www.nichd.nih.gov/
  36. https://www.niehs.nih.gov
  37. https://www.nimhd.nih.gov/
  38. https://www.nhlbi.nih.gov/health-topics
  39. https://obssr.od.nih.gov/
  40. https://www.nichd.nih.gov/health/topics
  41. https://rarediseases.info.nih.gov/diseases
  42. https://beta.rarediseases.info.nih.gov/diseases
  43. https://orwh.od.nih.gov/

References