What is idiopathic thrombocytopenic purpura and how to treat it

Idiopathic thrombocytopenic purpura is an autoimmune disease in which the body's own antibodies destroy blood platelets, resulting in a marked reduction in this type of cell. When this happens, the body has a harder time stopping bleeding, especially in the case of wounds and blows.

Due to the lack of platelets, it is also very common that one of the first symptoms of thrombocytopenic purpura is the frequent appearance of purple spots on the skin in various parts of the body.

Depending on the total number of platelets and the symptoms presented, the doctor may advise only more care to prevent bleeding or, then, start treatment for the disease, which usually includes the use of drugs to decrease the immune system or to increase the number of cells in the blood.

Main symptoms

The most frequent symptoms in case of idiopathic thrombocytopenic purpura include:

• Ease of getting purple spots on the body;
• Small red spots on the skin that look like bleeding under the skin;
• Ease of bleeding from the gums or nose;
• Swelling of the legs;
• Presence of blood in the urine or feces;
• Increased menstrual flow.

However, there are also many cases in which purpura does not cause any symptoms, and the person is diagnosed with the disease only because he / she has less than 10,000 platelets in the blood / mm³.

How to confirm the diagnosis

Most of the time the diagnosis is made by observing the symptoms and blood test, and the doctor is trying to eliminate other possible diseases that cause similar symptoms. In addition, it is also very important to assess whether any medications, such as aspirin, that may be causing these types of effects are being used.

Possible causes of the disease

Idiopathic thrombocytopenic purpura happens when the immune system begins, in a wrong way, to attack the blood platelets themselves, causing a marked decrease in these cells. The exact reason why this happens is not yet known and, therefore, the disease is called idiopathic.

However, there are some factors that seem to increase the risk of developing the disease, such as:

• Be woman;
• Having had a recent viral infection, such as mumps or measles.

Although it appears more frequently in children, idiopathic thrombocytopenic purpura can appear at any age, even if there are no other cases in the family.

How the treatment is done

In cases where idiopathic thrombocytopenic purpura does not cause any symptoms and the number of platelets is not very low, the doctor may advise only to be careful to avoid bumps and wounds, as well as to carry out frequent blood tests to assess the number of platelets.

However, if there are symptoms or if the number of platelets is very low, treatment with medications may be advised:

• Medicines that lower the immune system, usually corticosteroids such as prednisone: decrease the functioning of the immune system, thus reducing the destruction of platelets in the body;
• Injections of immunoglobulins: lead to a rapid increase in platelets in the blood and usually the effect lasts for 2 weeks;
• Medicines that increase platelet production, such as Romiplostim or Eltrombopag: cause the bone marrow to produce more platelets.

In addition, people with this type of disease should also avoid using drugs that affect the functioning of platelets such as Aspirin or Ibuprofen, at least without the supervision of a doctor.

In the most severe cases, when the disease does not improve with the medications indicated by the doctor, it may be necessary to have surgery to remove the spleen, which is one of the organs that produces more antibodies capable of destroying platelets.

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