Immune Thrombocytopenia

What Is Immune Thrombocytopenia?

Immune thrombocytopenia — or immune thrombocytopenic purpura (ITP) — happens when the immune system, which fights germs and infections, attacks the body's platelets. Platelets are cells that stop bleeding by forming blood clots. Without enough platelets, kids with the condition bleed easily.

In most children, immune thrombocytopenia (throm-buh-sye-tuh-PEE-nee-uh) goes away within 6 months. But sometimes it can last longer, or come back after going away.

What Are the Signs & Symptoms of Immune Thrombocytopenia?

A child with immune thrombocytopenia may have:

• bleeding that happens easily, such as:
  • nosebleeds
  • bleeding from the gums
  • blood in the poop (stool) or pee (urine)
  • heavy and longer periods (in girls)
• bleeding under the skin that leads to:
  • easy bruising
  • small red or purple spots on the skin called petechiae (peh-TEE-kee-eye)
  • purple spots that look like bruises called purpura (PURR-pyur-ah)

Very rarely, immune thrombocytopenia can cause bleeding in the brain (a stroke).

What Causes Immune Thrombocytopenia?

Immune thrombocytopenia happens when the immune system attacks platelets. Viral infections often trigger this in children. Less commonly, another illness or autoimmune disease or a medicine can trigger ITP. Often, it isn't clear what triggers the immune system to attack platelets.

Who Gets Immune Thrombocytopenia?

Most cases of childhood immune thrombocytopenia happen in kids 1–7 years old. But it can happen in older kids and teens. Usually, the child is otherwise healthy and feels well.

How Is Immune Thrombocytopenia Diagnosed?

To diagnose immune thrombocytopenia, doctors:

• asks questions
• do an exam
• do blood tests to:
  • do a platelet count
  • make sure the other blood counts (red blood cells and white blood cells) are normal
  • look for signs of infection
  • check for other causes of low platelets

How Is Immune Thrombocytopenia Treated?

Treating immune thrombocytopenia depends on how severe the symptoms are. Children who only have bruising and red pinpoint spots may not need any treatment.

When needed, treatments may include:

• medicines that stop the immune system from attacking platelets, such as:
  • steroids
  • an IV injection of antibodies (immunoglobulins or rituximab) 
• medicines to help the body make more platelets
• surgery to remove the spleen because the spleen is where the platelets are removed from the blood. This is done only when a child has serious symptoms that don't improve with other treatments.

What Can Parents Do?

While they have immune thrombocytopenia, kids need to:

• avoid sports and activities (such as bike riding and contact sports) that could lead to injury and bleeding
• not take medicines that contain ibuprofen (such as Motrin or Advil) or aspirin, which make bleeding more likely

Most children with immune thrombocytopenia recover fully within a few months. Help your child by:

• going to all doctor's appointments
• following the doctor's advice on which activities are OK and which to avoid
• contacting the doctor and going to a hospital right away if your child has a head injury
• making sure your child avoids any medicines as your doctor recommends
• calling the doctor if your child has new symptoms of bleeding, bruising, or red or purplish spots on the skin