|  | Conditions Treatments | Blood Disorders

Immune-Mediated Thrombocytopenia in Humans

Thrombocytopenia is defined as an abnormal reduction in platelet count leading to an increased tendency to bruise or bleed. Platelets, also known as thrombocytes, are the tiny cells in the blood that are responsible for blood clotting. Immune-mediated thrombocytopenia is also known as idiopathic thrombocytopenic purpura (ITP; purpura because of the tiny bruises associated with the condition). ITP occurs when the body's own immune system destroys the blood platelets. In children ITP occurs as an acute self-limiting condition, and in adults it occurs as a chronic condition.

  1. Symptoms

    • According the the Heart and Lung institute, low platelet count itself does not have any symptoms; it is the bleeding caused by the low platelet count that may produce symptoms, which may include the following:

      Small red spots on the surface of the skin that look like a rash. This is called petechiae and is a result of spontaneous bleeding under the skin.

      Spontaneous unexplained purple bruising on the skin and mucous membranes (like inside the mouth). This is called purpura and is caused by spontaneous bleeding under the skin.

      There may be a hematoma under the skin. This feels like a soft lump and is the result of more bleeding under the skin than would cause a bruise. It is made up of clotted blood.

      Excessive nosebleeds and bleeding of the gums. Women may experience excessive bleeding during menstruation; bleeding into the brain is exceedingly rare.

    Corticosteroid Treatments

    • Adults and children who do not have symptoms may not need treatment. Drug treatments, where used, may include corticosteroids, which work by reducing the effect of the immune system, leading to an increase in platelet count as fewer platelets are destroyed. Steroids have some undesirable side effects, however, and some patients get more ill after they have been stopped.

    Immune Globulin Treatment

    • Immune globulin, a solution high in antibodies extracted from donated blood, may be used to treat severe bleeding by rapidly and temporarily increasing platelet count. It is given intravenously, meaning by a needle inserted into a vein.

    Treatments with Thrombopoeitic Agents

    • Thrombopoeitic agents are drugs that directly stimulate the bone marrow to produce blood cells, including platelets. These may be given to adults. These drugs are only used if all other interventions do not reduce the risk of bleeding.

    Surgical Treatment

    • If you suffer from immune-mediated thrombocytopenia It may be necessary for you to have your spleen removed (splenectomy). The spleen is a small organ in the upper left side of your abdomen that is responsible for helping your body to fight infection. In ITP the spleen is responsible for the destruction of the platelets, so removing it may increase your platelet count. The disadvantage of this is that you will be more susceptible to infections as a result. Your doctor will discuss with you what you can do to minimize your chances of infection if you have a splenectomy. Some ITP patients will need a platelet transfusion before surgery to minimize the chances of bleeding.

    Risks

    • The most serious complication associated with this condition is hemorrhage (excess bleeding). The most dangerous type of bleeding is bleeding into the brain (intercranial hemmorhage), though this is extremely rare. The chance of dying from bleeding increases significantly if you are over 60. The condition spontaneously resolves itself in 80% of childhood cases, but this rarely happens with adults.

Blood Disorders - Related Articles