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Pú idiopathic thrombocytopêonicacute;tica: symptoms, causes and treatment

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Pú idiopathic thrombocytopêonicacute;tica: symptoms, causes and treatment
Pú idiopathic thrombocytopêonicacute;tica: symptoms, causes and treatment

Idiopathic thrombocytopenic purpura, also called immune, autoimmune or isoimmune thrombocytopenic purpura or simply ITP, is an autoimmune disease in which the body's own antibodies destroy blood platelets, resulting in a marked reduction in this type of cells. When this happens, the body has a harder time stopping bleeding, especially from wounds and blows.

Due to the lack of platelets, it is also very common for one of the first symptoms of thrombocytopenic purpura to be the frequent appearance of purple spots on the skin in various parts of the body.

Depending on the total number of platelets and the symptoms presented, the doctor may only advise greater care to avoid bleeding or, then, start treatment for the disease, which usually includes the use of drugs to decrease the immune system or to increase the number of cells in the blood.

Main symptoms

The most common symptoms of idiopathic thrombocytopenic purpura include:

  • Easy to get purple spots on the body;
  • Small red dots on the skin that look like bleeding under the skin;
  • Ease of bleeding from gums or nose;
  • Swelling of the legs;
  • Presence of blood in urine or feces;
  • Increased menstrual flow.

However, there are also many cases in which purpura does not cause any symptoms, and the person is diagnosed with the disease only because they have a blood platelet count of less than 10,000/mm³.

How to confirm the diagnosis

The initial diagnosis is made from the observation of the signs and symptoms presented by the person.However, a blood count is also indicated to assess the amount of platelets found in the blood, which in the case of ITP is below 100,000 platelets, being in most cases the only change detected in this test.

It is also requested by the doctor to perform other tests to exclude other changes that may have similar symptoms and laboratory results. Thus, reticulocyte count, VSH, direct coombs, ABO and Rh blood typing, tests to assess liver and thyroid function, ANA test and tests for infections such as HIV, H. pylori, HCV and HBV.

In addition, in the case of people under 20 years of age, immunoglobulin A, G and M (IgA, IgM and IgG) measurements may also be requested.

Possible causes

Idiopathic thrombocytopenic purpura occurs when the immune system mistakenly begins to attack the blood platelets themselves, causing a marked decrease in these cells.The exact reason why this happens is not yet known and, therefore, the disease is called idiopathic.

However, there are some factors that seem to increase the risk of developing the disease, such as being female and/or having had a recent viral infection, such as mumps or measles. Although it appears more frequently in children, idiopathic thrombocytopenic purpura can develop at any age, even if there are no other cases in the family.

How the treatment is done

In cases where idiopathic thrombocytopenic purpura does not cause any symptoms and the number of platelets is not very low, the doctor may just advise being careful to avoid blows and wounds, as well as having frequent blood tests to evaluate the number of platelets.

However, if symptoms are present or the number of platelets is very low, treatment with medication may be advised:

  • Drugs that decrease the immune system, usually corticosteroids such as prednisone: decrease the functioning of the immune system, thus reducing the destruction of platelets in the body;
  • Immunoglobulin injections: lead to rapid increase in blood platelets and usually lasts for 2 weeks;
  • Drugs that increase platelet production, such as Romiplostim or Eltrombopag: cause the bone marrow to produce more platelets.

Furthermore, people with this type of illness should also avoid using drugs that affect platelet function such as Aspirin or Ibuprofen, at least without a doctor's supervision.

In the most severe cases, when the disease does not improve with the medication prescribed by the doctor, surgery may be necessary to remove the spleen, which is one of the organs that produces more antibodies capable of destroying platelets.

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