ITP (Idiopathic Thrombocytopenic Purpura)

ITP (Idiopathic Thrombocytopenic Purpura)

Idiopathic Thrombocytopenic Purpura (ITP) is a disease that causes the body to bruise or bleed easily. This happens due to the low number of platelets in the body.

ITP can occur in both children and adults. This condition is not contagious so direct interaction with sufferers does not cause someone to become infected.

Platelet cells or platelets are blood cells that play a role in the blood clotting process to stop bleeding. When the platelet count is low, a person will easily bruise or bleed.

Causes of ITP

The cause of ITP is not known with certainty until now. However, the main suspected cause of ITP is a disorder of the immune system called an autoimmune disease .

In ITP sufferers, the body's immune system considers platelets as foreign objects that are dangerous so that antibodies are formed to attack the platelets. This is what causes the platelet count to decrease.

Apart from that, the following things can also trigger the appearance of ITP:

  • Viral or bacterial infection, usually in children
  • Vaccination
  • Exposure to poisons or hazardous chemicals, such as insecticides
  • Other autoimmune diseases, eg lupus
  • Chemotherapy treatment

ITP symptoms

The main symptoms of ITP are the appearance of red rashes or bruises on various parts of the body and bleeding that is difficult to stop when injured. Some of the additional signs and symptoms caused by ITP are:

  • Excessive fatigue
  • Nosebleed
  • Spots of blood in urine or stool
  • Bleeding gums, especially after dental work
  • Excessive bleeding during menstruation

In children, ITP sometimes causes no symptoms. When they do appear, the symptoms are usually mild and last less than 6 months (acute). ITP symptoms can also last more than 6 months (chronic), but usually occur in adults.

When to see a doctor

ITP is characterized by bleeding that can occur in all parts of the body. Consult your doctor if you experience frequent bleeding, such as nosebleeds , bleeding gums, or bruising, especially if the bleeding occurs spontaneously or without previous injury.

ITP sufferers need to be careful in their activities, especially activities that involve physical contact and have a risk of causing injury or injury, for example playing soccer. If you have a wound, make an effort to stop the bleeding by pressing on the bleeding area.

If the bleeding does not stop, immediately go to the emergency room (ER) at the nearest hospital to get medical help.

ITP diagnosis

The doctor will examine all parts of the patient's body to detect bruising or bleeding. If there is bleeding due to a wound, the doctor will examine the condition of the wound and treat it immediately.

Next, the doctor will do a blood test to see the platelet count . The normal platelet count is between 150,000–400,000 per microliter. ITP sufferers have platelets below normal values. The lower the platelets, the risk of bleeding will increase.

There are no tests that can confirm ITP. Therefore, the doctor will look for and rule out the possibility of bleeding and low platelet count caused by other conditions. Examinations that can be carried out include:

  • Liver function test
  • Examination of kidney function
  • Bone marrow aspiration

ITP treatment

Mild ITP does not require special treatment, but the doctor will monitor and check platelets regularly to prevent bleeding.

Whereas in ITP which is more severe, the doctor will provide treatment to keep the platelet count from falling so that bleeding does not occur.

ITP treatment can be given in the form of:


A number of medicines that doctors give to treat ITP are:

  • Corticosteroids
    Corticosteroids function to suppress the immune system and platelet count. The doctor will give instructions to the patient to stop taking this drug if the platelet count returns to normal.
  • Eltrombopag
    This type of drug is used to help the bone marrow to produce more platelets.
  • Rituximab
    Rituximab works to relieve the body's immune system response that causes destruction of platelets.
  • Intravenous immune globulin ( IVIg ) IVIg is a drug given to increase the number of platelets when other drugs are no longer effective in treating ITP. This drug is also used to increase blood counts when patients experience bleeding before undergoing surgery.


If ITP is severe and drugs are no longer effective in treating symptoms, the doctor will perform spleen removal surgery or splenectomy.

The splenectomy procedure aims to prevent the destruction of platelets in the spleen. However, this surgical procedure is rarely done because of the risk of infection .

ITP complications

A complication of ITP that can occur is bleeding, both in the digestive tract and in other organs of the body. If it occurs in the brain, bleeding can endanger the life of the sufferer, but this condition is very rare.

The use of corticosteroids is quite effective in treating ITP. Even so, this drug has the potential to cause side effects if consumed in the long term. Side effects that can appear are:

  • Cataract
  • Osteoporosis
  • Diabetes
  • Loss of muscle mass

Surgical removal of the spleen can increase the risk of getting a bacterial infection, because the spleen plays a role in fighting infection.

ITP sufferers who are pregnant can have a normal pregnancy and delivery period. However, consult with your obstetrician about what things need to be done and avoided, both during pregnancy and childbirth.

It should be noted, babies born to ITP sufferers are at risk of having a low platelet count. If this happens, the pediatrician will carry out intensive monitoring of the baby for several days.

Under normal conditions, the baby's platelet count will decrease before finally rising again. However, if the baby's platelet count does not increase for several days, the doctor will provide treatment to speed up the increase in platelets.

ITP prevention

Although ITP itself cannot be prevented, there are several steps that can be taken to prevent bleeding, namely:

  • Protect yourself from things that could cause injury.
  • Consult your doctor about medicines that are safe for you. The doctor will forbid the use of drugs that can affect platelet levels and increase the risk of bleeding, such as aspirin or ibuprofen.
  • Call your doctor right away if you have signs of infection, such as a fever. This is especially important if you have ITP or have had your spleen removed .
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