Easy bruising and excessive bleeding? These could be signs of a disorder called Immune Thrombocytopenia, say experts


Jaipur, September 2022.

In the backdrop of Global ITP (Immune Thrombocytopenia) awareness month, leading healthcare professionals in the city have laid emphasis on the need to create awareness around the condition- an autoimmune blood disorder that occurs when the platelet count becomes too low. Immune thrombocytopenia (ITP) occurs with an incidence rate of 1.6 to 3.9 per 100,000 patient-years, which increases with age and has a slight female preponderance. It is a chronic disease in which patients must take lifelong treatment and hence, experts stress upon its appropriate management.

In ITP, the immune system attacks the platelets, cells that help the blood clot, thereby, decreasing their count. A normal platelet count is between 150,000 and 450,000 but with ITP, the count is less than 100,000.This low platelet count prevents the blood from clotting properly leading to easy bleeding and bruising.

ITP symptoms vary from none to severe. Easy bruisability, heavy and prolonged menstrual flow, bleeding in the mouth, nose, and gums could be some of the common symptoms at presentation according to Dr. Mitu Shrikhande, Senior Consultant Haemato-Oncology, Fortis Hospital, Vasant Kunj. A low platelet count raises the risk of bleeding.  Lower the platelet count higher is the risk of bleeding. Since bleeding symptoms may occur in other serious health issues as well, it is vital to seek a proper diagnosis to rule out other potential causes. To keep the symptoms under control, we advise a routine blood count check. ITP is curable, and there are numerous therapies available. The doctor will advise the best course of treatment based on the symptoms of the patient.

The diagnosis of ITP is usually done through a blood test to check the platelet levels. In some cases, a physical examination is also conducted to check for bleeding on or under the skin. The treatment course depends on the platelet count and the frequency of bleeding. However, it is observed that patients often change doctors which might lead to discontinuation in treatment. As Dr.Vishnu Sharma, Hematologist, Hemato-oncologist, and bone marrow transplant physician. Associate Professor (medicine), SMS Medical college and Hospital, Jaipur points out, “ITP patients change treating physicians frequently due to anxiety of inconsistent platelet counts. They also end up doing frequent testing and self-medication as per testing results. This hampers the management and might worsen the condition. Patients need to understand that with ITP, the platelet count keeps fluctuating and minor changes need not be a cause of worry. It is advisable that patients adhere to a treatment regime and undergo testing post-discussion with their treating physicians.”

The treatment for ITP is usually through oral medication. In severe cases, platelet transfusion and intravenous immune globulin (IVIG) are prescribed. ITP, per se, is not a life-threatening condition and majority of the patients lead normal lives. It can be managed well by making some lifestyle changes and appropriate treatment. In a few cases, patients might be advised to avoid certain medications that affect platelets. Some milder cases might only regular monitoring but no immediate treatment.