Idiopathic Thrombocytopenic Purpura - ITP

Idiopathic Thrombocytopenic Purpura (ITP) is a disease characterized by isolated low platelet count with normal bone marrow. It causes a classic purpuric rash and a tendency to bleed.

What are blood platelets?
Platelets are cells that are produced in the bone marrow and who play an important role in the clotting process. They travel in the blood vessels and stop bleeding by creating traffic – a clot which stops the blood from leaving the body. A healthy body has between 140,000 and 440,000 platelets, while someone with ITP only has 50,000 (in some cases, that number is even lower).

The disease is characterized by a purpuric rash, made of small red dots. These are sub-dermal blood hemorrhages. Children who have ITP also have the tendency to bleed from their nose or gums. Sometimes, blood may appear in their urine. Rarely will a child bleed internally. Usually these signs appear a few days or weeks after the infection.

How did my child get this disease?
The name ‘idiopathic’ denotes that the cause is unknown. The disease usually occurs after a viral infection which causes the immune system to attack the platelets.

What is an autoimmune disease?
An autoimmune disease is a type of disease where the immune system creates antibodies against the body itself. ITP is a type of autoimmune disease; the immune system creates antibodies against the body’s platelets, causing problems with blood clotting.

The average age for childhood ITP is five. Eighty percent of children with ITP recover after six months.

Diagnosis of ITP

  • Blood Count: low number of platelets
  • Blood Smear – done by a hematologist
  • Medical history
  • Physical Examination
  • Bone Marrow Samples

Treatment of ITP
Treatment depends on the doctor’s recommendation and the child’s condition. Some cases only require monitoring and other cases require more aggressive treatment such as medication.

Medication used for treating ITP

  • Anti D: Anti D is an intravenous medication. D is a protein and antibody found in red blood cells. A transfusion with anti D stops the destruction process of the platelets.
  • Immunoglobolin: This is another type of intravenous medication. Also called IVIG.
  • Steroids: Steroids suppress the immune system and lower the production of antibodies in the body which fight the body.

These medications do not heal the disease; rather they provide a brief respite. Sometimes treatment needs to be repeated a few weeks or months later if the number of platelets in the body decreases.