Immune Thrombocytopenic Purpura affects an estimated 5.3 in every 100,000 children. For adults the number is higher. Being a fairly rare disease, most people may not know about it or know very little. So, what is Immune Thrombocytopenic Purpura?
Immune Thrombocytopenic Purpura is a rare blood disease that is characterised by low platelet levels. Platelets are a type of blood cell whose major function is to prevent/ stop bleeding. Put simply, when one is cut, it is the work of platelets to ensure you don’t bleed endlessly. In people with Immune Thrombocytopenic Purpura, the number of platelets is significantly low leading to excessive bruising and bleeding. This can occur after a viral infection with HIV, hepatitis or bacterial infection with H. Pylori. The immune system for some reason then begins to attack platelets and destroy them therefore leading to a decrease in their number. The incidence of Immune Thrombocytopenic Purpura occurrence is higher in young women and those with Rheumatoid arthritis or lupus.
Some of the signs and symptoms to look out for include; easy bruising, excessive bleeding, small reddish-purple spots on the lower legs (Petechiae), unusually heavy periods, nose bleeding, bleeding from the gums and blood in urine or stool. It is important to see a doctor as soon as you notice these signs. In some cases, there can be bleeding into the brain which if not attended to with urgency can be fatal. In affected pregnant women, the risk of postpartum haemorrhage is high and therefore should be closly monitored.
Diagnosis would include, several blood tests: a complete blood count, bleeding time and antiplatelet antibody test. Occasionally a bone marrow aspirate may also be required.
After diagnosis there are several different approaches in terms of management that the doctor may opt to take. For children and those with mild Immune Thrombocytopenic Purpura for instance, the doctor may recommend regular platelet checks with no medication. On the other hand, most adults will be put on medication such as steroids, immune globulin, romiplastin, rituximab among others. This all work to boost your platelet count. During an emergency blood transfusion may be necessary. In the event that the condition worsens despite medication adherence, the doctor may consider a splenectomy (removal of your spleen) which is the organ that destroys your platelets. This, however, has its own risks such as increased susceptibility to infection.
Although rare, Immune Thrombocytopenic Purpura is generally a manageable disease if diagnosed and managed early.