What Are TTP and ITP?

Platelets are cells in the blood responsible for clotting. When the platelet count drops below the normal level, this condition is known as thrombocytopenia. It may be caused by drugs, antibodies, bone marrow dysfunction or infections. ITP and TTP are conditions resulting from decreased platelets.

Idiopathic Thrombocytopenic Purpura (ITP)

• ITP is an acquired disorder due to destruction of platelets by immune mediated antibodies and also by inhibition of platelet release from the bone marrow cells. It takes an acute course in children, following an infection. In adults, it is a chronic condition. Secondary ITP is associated with disorders like systemic lupus erythematosis (SLE), HIV and hepatitis C. Patients with ITP have a tendency to bleed and bruise very easily.

Thrombotic Thrombocytopenic Purpura (TTP)

• TTP is characterized by small clot formation in microvascular circulation. Thrombocytopenia results from platelet consumption, and tissue injury ensues from decreased blood flow to organs. Primary TTP is associated with acquired autoantibodies. TTP is termed secondary when caused by metastatic cancer, systemic infection, organ transplantation, radiation exposure, chemotherapy, drugs or disseminated intravascular coagulation (DIC). Patients with TTP have a tendency to bleed and bruise also. These patients are also anemic, due to destruction of red blood cells. Since TTP involves multiple organ systems, it presents a wide variety of symptoms including headache, visual disturbances, vertigo, personality change, confusion, lethargy, coma, seizures, paralysis, fever, chest pain, respiratory distress, abdominal pain, nausea, vomiting, diarrhea and joint and body aches.

Treatment of ITP and TTP

• ITP usually improves on its own over a few days to weeks without treatment. Children with ITP should avoid contact sports due to the risk of splenic rupture. Monitoring of blood platelets is required until the patient is seen to be recovering.

  TTP can be a life-threatening condition and requires hospitalization. Plasma exchange to remove antibodies from blood, transfusion of blood and platelets as necessary, and corticosteroid administration are the mainstays of treatment.