We need platelets for proper blood clotting. These elements are essential when we get wounded. They gather into the affected area to prevent the blood from flowing out of the body. They can be useful, but they can also have certain disorders that can stop them from doing their functions.
ITP or immune-mediated or idiopathic thrombocytopenic purpura is a health condition where the person has a low platelet count, but the underlying cause is unknown. A platelet count below 150,000 platelets per microliter of blood can already be considered thrombocytopenic. The standard threshold should be between 150,000 to 450,000 platelets per microliter of blood.
The ITP is a kind of thrombocytopenic purpura, the red or purple spots on the skin caused by low platelet count. The rash that exists can cause bleeding which can be life-threatening. People with acute ITP are prone to infection.
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It is an autoimmune disease, a condition in which the body’s antibodies cannot recognize the cells and platelets as an essential part of the body. As a result, they destroy these elements just like how they do to antigens or virus. Children who have had viral infections may also experience acute ITP.
For some, they may consider ITP as a mild problem. It is because this condition disappears after two weeks on adults, and within 6 to 12 months on 80% reported case on children. If this disease continues, that is the time that patients seek medical treatment.
Diagnostic tests must be done to determine the person’s platelet count. One of the first and universal screening is CBC or complete blood count. It can determine the level of platelets present in the body as well as the other components of the blood. The doctor will also check if the blood and its components have abnormal growth.
A physical examination should also be done to check the signs of symptoms in the different parts of the body. Another way to find the causes of the health condition of the patient is to check the spleen to see if it collects more platelets than the normal range.
Further investigations must also be conducted to obtain accurate findings. It may include bone marrow biopsy performed on people over the age of 60 in which a small sample of the tissue inside the bones are evaluated to identify if it has regular activity and has the capacity to produce healthy platelets. This procedure can also help the doctor assess the increasing production of megakaryocytes before the disease is declared as ITP.
Signs and symptoms of ITP
The following symptoms may show up once the person’s platelets drop down to 20,000 per microliter of blood. So, make sure to observe your body and report these cases to your doctor.
- Petechiae – red spots on the skin caused by bleeding of the damaged capillary blood vessels
- Gum bleeding
- Heavy menstrual period
On the other hand, patients with 10,000 platelets or less will have hematomas formed in the mucous membranes. This spot is a clotted blood under the skin that looks like a lump. The bleeding time will take longer no matter the cause is just a slight abrasion.
This condition can be fatal when the person has only 5,000 platelets or less. Bleeding can occur even on internal organs like a brain (intracerebral hemorrhage) or intestinal tract (lower gastrointestinal bleeding). Besides, your immune system is not functioning correctly during this time. Instead of it protecting your body against the attacking bacteria and virus, it destroys your own cells.
The treatment should be based on the severity of the issue. It is best recommended if signs of bleeding are seen on the patient. One of the initial steps is giving steroids. It uses various medications to regulate the immune system. The dosage of these drugs should be based on the platelet count of the affected individual. It is, therefore, necessary to determine it through a blood testing and other diagnostic tests.
Infusions of methylprednisolone are provided during emergency situations. In some cases, oral prednisolone is recommended to decrease the bleeding. These drugs should be administered until the platelet count has normalized.
The patient will experience a relapse while the dose of steroid is reduced but this side effect is just temporary. As much as possible, the doctor will not recommend using long-term steroids due to its adverse effects that can bring out another health problem such as cataract and osteoporosis.
If the problem causes the spleen enlargement and the patient’s body is not responsive to steroids provided, a splenectomy or removal of the spleen is advised. This procedure is effective to reduce the destruction of platelets in the body. However, this kind of treatment can be risky because it can potentially cause bleeding.
Platelet transfusion is often provided during excessive bleeding or emergency cases to replace the lost platelets in the body. However, this procedure can fail to increase the platelet count in long-term. It happens because the primary cause of the health condition is an autoimmune disease that attacks the platelets. Therefore, it can also destroy even the platelets from the donor.
ITP is a health condition that should not be taken for granted. Anyone can die if affected by this disease most especially if the body cannot tolerate its effects. Every year, 50-100 cases/million of the world’s population were reported to have suffered from this problem, and half of that number were children. There are growing numbers of death due to ITP. About 96% of them were adults 45 years and older.
It is, therefore, crucial to monitor your platelet count if you have been suspected to have a low number of platelets. But before the problem gets worse, make sure to seek a consultation so the doctor can detect the problem quickly. You must make sure to avoid any activity that can trigger bleeding. If symptoms already persist, ensure to follow your physician’s guideline. Also, practicing a healthy lifestyle will at least relieve the effects of the disease.