COMPLICATIONS:

-A rare complication of ITP, bleeding into the brain, which can be fatal.

-Pregnancy

In pregnant women with ITP, the condition doesn’t usually affect the baby. But the baby’s platelet count should be tested soon after birth.

If you’re pregnant and your platelet count is very low or you have bleeding, you have a greater risk of heavy bleeding during delivery.

DIAGNOSIS:

1.  M.D. will exclude other possible causes of bleeding and a low platelet count, such as an underlying illness or medications being the cause of low platelet count, not ITP.

2. Take a history of the child or adult, including their family.

3. Complete blood count (CBC).  Looks at red blood, white blood and platelet cells counts.

4 Blood smear. This test is often used to confirm the number of platelets observed in a complete blood count.

5.Bone marrow exam. This test may be used to help identify the cause of a low platelet count, though the American Society of Hematology doesn’t recommend this test for children with ITP.  All cells (platelets) are produced in the bone marrow.  Bone marrow will be normal because a low platelet count is caused by the destruction of platelets in the bloodstream and spleen — not by a problem with the bone marrow.

TREATMENT:

People with mild idiopathic thrombocytopenic purpura may need nothing more than regular monitoring and platelet checks. Children usually improve without treatment. Most ITP adults will eventually need treatment as it gets worse or becomes chronic.

1-The M.D will stop any meds that inhibit platelet production=Anti-platelet Meds (Ex. aspirin, ibuprofen (Advil, Motrin IB, others), ginkgo biloba and warfarin, also known as Coumadin)

2-Drugs that suppress your immune system.  M.D. might start you on oral corticosteroid, such as prednisone and when platelet count is normal gradually decrease the dosing till no longer on it.  The problem is that many adults experience a relapse after stopping corticosteroids. A new course of corticosteroids may be pursued, but long-term use of these medications is unusual, due to its long term side effects. These include cataracts, high blood sugar, increased risk of infections and thinning of bones (osteoporosis).

3-Injections to increase your blood count (Ex. immune globulin (IVIG). This drug may also be used if you have critical bleeding or need to quickly increase your blood count before surgery. The effect usually wears off in a couple of weeks.

4-Drugs that boost platelet production.  Examples romiplostim (Nplate) and eltrombopag (Promacta) — help your bone marrow produce more platelets.

5-Other immune-suppressing drugs. Rituximab (Rituxan) helps reduce the immune system response that’s damaging platelets, thus raising the platelet count.

6-Removal of your spleen.

7-Other drugs. Azathioprine (Imuran, Azasan) has been used to treat ITP. But it can cause significant side effects.

Review all treatments with your personal doctor.