Idiopathic Thrombocytic Purpura or Immune thrombocytopenia purpura also known as IDP, is a condition in which there is a low platelet count, but a normal bone marrow condition.
IDP is a type of thrombocytic purpura in which the cause of the condition is not particularly known.
Purpura is a condition in which there are red or purple colored spots on the skin due to bleeding underneath the skin caused due to platelet disorders, vascular disorders, coagulation disorders, etc.
SIGNS & SYMPTOMS OF IDP
- Bruising in the extremities
- Formation of red or purple spots on the skin
- Bleeding from the nose
- Bleeding from the gums
- When platelet count is below 10000 per μl;
- Blood in the urine & stool
- Excessive menstrual bleeding
- Formation of blood masses in the mouth
- Formation of blood masses in other mucous membranes
- Easily bleeding from minor wounds & abrasions.
- When platelet count is below 5000 per μl;
- Intracerebral hemorrhage
- Bleeding inside the skull or brain
- Bleeding within the subarachnoid space
- Low gastrointestinal bleeding
- Higher chance of bleeding in pregnant women
- Easy internal bleeding in case of a blunt abdominal trauma.
- IDP is an autoimmune disease
- Antibodies attack the platelets
- Macrophages, a type of WBC attack the platelets by engulfing them
- Impaired production of the glycoprotein hormone thrombopoietin, which is the stimulant for platelet production, may be a contributing factor to the reduction in circulating platelets.
RISK FACTORS OF IDP
- The condition can be triggered by infection from the following infections:
- Higher risk factor in young women
- Presence of existing conditions or diseases like:
- Rheumatoid arthritis
- Systemic Lupus
- Evans Syndrome
- Antiphospholipid syndrome.
- Primary diagnosis is done by exclusion of other causes that can lead to such a condition.
- Detection of any other blood abnormalities & presence of physical conditions other than bleeding.
- Certain secondary factors/disorders/diseases are assessed for, which can contribute to formation of a condition like IDP;
- a) Leukemia
- b) Cirrhosis
- c) Von Willebrand factor deficiency
- d) Onyalai
- e) Use of medications like quinine & heparin.
- Bone marrow biopsy: An analysis of Bone marrow to check for an increase in the production of megakaryocytes, which can help in establishing for diagnosis of IDP.
TREATMENT FOR IDP
- Corticosteroids drugs, in urgent situations IV infusion of dexamethasone is used, whereas in less severe situations, oral prednisolone is used.
- IV administration of Rho(D) immune globulin [Human; Anti-D].
- Immunosuppressants such as mycophenolate mofetil and azathioprine.
- Use of chemotherapy agents like vincristine.
- IV infusion of intravenous immunoglobulin (IVIg)
- Thrombopoietin receptor agonists are drugs that stimulate platelet production in the bone marrow. Two such agents are currently used:
a) Romiplostim administered by subcutaneous injection,
b) Eltrombopag, an orally administered agent.
- Dapsone, an anti infective medication is used as second line treatment of IDP.
- Use of monoclonal antibody, rituximab.
- Surgery: Splenectomy, surgical removal of spleen, because macrophages consume the platelets in the spleen & thus the surgical removal of spleen can reduce platelet destruction.
- Platelet transfusion
- Eradication of H.Pyroli.
No known prevention for IDP exists.