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AutoimmuneICD-10: D69.3Affects approximately 3–4 per 100,000 adults and 5 per 100,000 children annually

Immune Thrombocytopenia

Also known as: ITP, Idiopathic Thrombocytopenic Purpura

ITP is an autoimmune disorder in which the immune system destroys platelets, the blood cells responsible for clotting, leading to easy bruising and bleeding. In children, ITP often follows a viral infection and resolves on its own. In adults, it tends to be chronic but can be effectively managed with medications.

Symptoms

Easy or excessive bruising (purpura)
Petechiae (pinpoint red dots, especially on lower legs)
Prolonged bleeding from cuts
Bleeding from gums or nose
Blood in urine or stool
Heavy menstrual periods
Fatigue

Causes

  • Autoantibodies targeting platelet surface proteins
  • Increased platelet clearance by the spleen
  • Impaired platelet production in bone marrow
  • Triggered by viral infections in children

Risk Factors

  • Female sex in adults (2–3 times more common)
  • Age 20–50 in adults; age 2–6 in children
  • Recent viral infection (especially in children)
  • Other autoimmune conditions (lupus)
  • Chronic infections (H. pylori, hepatitis C, HIV)

Diagnosis

  • CBC showing isolated thrombocytopenia
  • Peripheral blood smear to evaluate platelets
  • Exclusion of other causes of low platelets
  • Testing for H. pylori, hepatitis C, and HIV

Treatment

  • Observation for mild cases without significant bleeding
  • Corticosteroids (prednisone, dexamethasone) as first-line
  • IVIG for rapid platelet increase
  • Thrombopoietin receptor agonists (eltrombopag, romiplostim)
  • Rituximab for refractory cases
  • Splenectomy for chronic, medication-resistant ITP

Prevention

  • No known prevention for ITP
  • Avoid medications that impair platelet function unless directed by your doctor

When to See a Doctor

  • Unexplained bruising or petechiae
  • Bleeding from minor cuts doesn't stop
  • Nosebleeds, gum bleeding, or blood in urine or stool
  • Unusually heavy menstrual bleeding

Frequently Asked Questions

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