Idiopathic thrombocytopenia purpura is a side effect of an autoimmune disease that affects blood platelets and has no cure, but has a few treatments.
This condition generally affects “2-4 people out of 100,000 people,” (Lambert & Gernsheimer, 2017). There is currently no known reason for why it occurs and researchers believe that this disease is autoimmune. For people working in healthcare it is important for them to know about this condition because they are at more risk for bleeding.
Idiopathic thrombocytopenia purpura is diagnosed when there is a complete blood count that shows platelet numbers below 150,000/mm3. This condition is “not a disease but rather a complication of other disorders,” (Hoffman 2017) and is usually a complication from an autoimmune disorder. Acute idiopathic thrombocytopenia purpura generally occurs “between the ages of two and six” (Hoffman 2017) and chronic generally occurs more “often in women between the ages of fifteen and forty” (Hoffman 2017). There are also “three peak periods,” (Lambert & Gernsheimer, 2017) of this disease that happen in “childhood, young adulthood, and elderly,” (Lambert & Gernsheimer, 2017). This condition has also been “associated with apoptosis, which is a process of cell death,” (Deng Gang, 2017)When this condition presents in childhood years it is “often rapid and resolves spontaneously” (Hoffman 2017) whereas when this condition presents in adults it usually “has a more insidious onset and rarely results in remission” (Hoffman 2017).
Generally, in children this condition usually happens as a result of “a viral infection or immunization” (Hoffman 2017). When this condition presents in adults it is usually because of “medication or secondary to an autoimmune disorder,” (Hoffman 2017). However, no matter what the case may be it “appears to be an immune system dysfunction,” (Hoffman 2017). This dysfunction causes the body to make “antiplatelet antibodies” (Hoffman 2017) which end up destroying platelets much faster than they are supposed to be. Normally platelets live “seven to ten days,” (Hoffman 2017) when someone has idiopathic thrombocytopenia purpura platelets are “destroyed in a matter of hours,” (Hoffman 2017)Some of the first signs and symptoms of having this condition include “easy bruising, petechiae, and a reduced platelet count,” (Hoffman 2017). As this condition progresses “bleeding from the nose, gums, or gastrointestinal tract,” (Hoffman 2017) may become apparent. In a worst-case scenario situation bleeding “in vital organs such as the brain,” (Hoffman 2017) can happen and be fatal.
Treatment for chronic idiopathic thrombocytopenia include the use of different types of medications and surgery as a last resort. A medication and dose that is usually used is “Predinsone 1mg/kg/d for 2-4 weeks” (Lambert & Gernsheimer, 2017). Another medication that has been proven “beneficial is glucocorticosteriods” (Hoffman 2017). These medications help because they “increase platelet count and decrease antiplatelet antibody production,” (Hoffman 2017). If these medications fail to work properly and in “extreme cases a splenectomy would occur,” (Hoffman 2017). However, “ASH guidelines try to delay a splenectomy from 6 months to 1 year,” (Lambert & Gernsheimer, 2017). While steroids are commonly used for the treatment of idiopathic thrombocytopenia purpura, however if the condition gets worse there is an alternative treatment that doesn’t involve surgery, and that is “intravenous immunoglobulin” (Samson, Guilhem, & al, 2017)