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Thrombocytopenic Purpura


What is thrombocytopenic purpura?

Thrombocytopenic purpura, or idiopathic thrombocytopenic purpura (ITP), is a bleeding disorder that occurs when your body does not have enough platelets. Platelets are cells that help your blood clot. ITP causes your immune system to create antibodies against platelets. Then your spleen destroys the platelets. You may not know that you have ITP early in the disease. Symptoms of ITP are often mild, but there may be times that bleeding can be severe and become life-threatening.

What increases my risk for ITP?

  • An immune system disorder, such as an autoimmune disease, lupus, HIV, or hepatitis C
  • A recent viral infection
  • Medicines, such as antibiotics, blood thinners, and medicines for high cholesterol or seizures
  • Vaccines, such as those for measles, mumps, and rubella

What are the signs and symptoms of ITP?

Your signs and symptoms will depend on your platelet count. You may bleed or bruise more easily or have tiny red or purple spots on your skin. You may feel tired or bleed from your gums or nose. You may have heavy menstrual bleeding or blood in your urine or bowel movement.

How is ITP diagnosed?

  • Blood tests are done to count your platelets and time how long it takes your blood to clot.
  • A bone marrow biopsy will show if your bone marrow is making platelets normally.

How is ITP treated?

Treatment will depend on your symptoms. Your healthcare provider may recommend that you have frequent tests and regular follow-up visits to watch for changes. You may need any of the following:

  • Medicines help your immune system and decrease destruction of platelets. Medicine may also be given to help increase platelet production and prevent bleeding.
  • Platelet transfusions may be given if your platelets are very low, or healthcare providers need to stop severe bleeding.
  • Surgery to remove your spleen may be needed to stop platelet destruction if your ITP is severe.

How should I care for myself when my platelets are low?

Examine your skin for minor bumps, scrapes, and cuts. These injuries can increase your risk for bleeding.

  • Use caution with skin and mouth care. Use a soft washcloth and a soft toothbrush to keep your skin and gums from bleeding. Use lip balm to prevent your lips from cracking. If you shave, use an electric shaver.
  • Do not strain when you have a bowel movement. This can increase pressure in your brain and could cause bleeding. Ask your healthcare provider about a stool softener or laxative if you are constipated. Do not use enemas or suppositories.
  • Avoid activities that may cause scratches or bruises. Wear shoes or slippers to protect your feet from injury. Ask your healthcare provider which activities are safe for you.
  • Do not take aspirin or NSAIDs. These medicines can cause you to bleed and bruise more easily.
  • Wear medical alert jewelry or carry a card that says you have ITP. Ask your healthcare provider where to get these items.

When should I contact my healthcare provider?

  • You have bleeding from your gums, mouth, or nose.
  • You have irregular or heavy menstrual bleeding.
  • You have blood in your urine or bowel movement.
  • You have more bruises or small red or purple spots on your skin.
  • You become confused or have trouble thinking clearly.
  • You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

  • You have bleeding that does not stop after you elevate and place pressure on the area.
  • You vomit blood or material that looks like coffee grounds.
  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.
  • You suddenly feel lightheaded, dizzy, or weak.
  • You have weakness on one side of your body, a severe headache, difficulty speaking, or a change in vision.
  • You have chest pain, tightness, or heaviness that spreads to your shoulders, arms, jaw, neck, or back.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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