Refractory immune thrombocytopenia

What is Refractory Immune Thrombocytopenia?

Refractory Immune Thrombocytopenia (ITP) is an autoimmune disorder resulting in low platelet (thrombocytopenia) count. In people with ITP, antibodies are formed against platelets, resulting in their destruction by the body's own immune system. Without enough platelets, the risk of bleeding increases. ITP is most common in children and women, and is usually diagnosed between the ages of 2 and 50.

ITP can either be acute or chronic. Acute ITP is typically the first stage of the disorder. It usually develops quickly and often resolves on its own within six months. Chronic ITP, on the other hand, is defined as having persisted for longer than six months and usually requires longer-term management.

Symptoms of ITP

Symptoms of ITP include:

• Easy or excessive bruising
• Prolonged bleeding from cuts
• Prolonged bleeding from the gums or nose
• Unusually heavy menstrual bleeding
• Unexplained bleeding in the skin (purpura)
• Fatigue

Diagnosis of ITP

Your doctor will begin by taking a thorough medical history and performing a physical examination. Your doctor may order tests to look for signs of ITP. These tests may include a complete blood count (CBC) to check the number of platelets, a slit-lamp examination to look for signs of bleeding in the eye, and a platelet antibody test to look for antibodies to platelets. Additional tests may be ordered to look for signs of infection or underlying diseases that can cause ITP.

Treatment of ITP

Treatment of ITP depends on the severity of the condition and range from no treatment at all to long-term immunosuppressive therapy. Treatment options may include:

• Watchful waiting: In mild cases of ITP, your doctor may recommend watchful waiting to see if your condition improves on its own. Your doctor may perform follow-up CBC tests to monitor your platelet levels.
• Medication: Your doctor may prescribe medications such as corticosteroids, immunoglobulins, or monoclonal antibodies to help increase your platelet count.
• Surgery: In some cases, your doctor may recommend removing your spleen (splenectomy). Your spleen is involved in destroying platelets, so removing it may help increase your platelet count.
• Blood transfusions: In some cases, your doctor may recommend a blood transfusion to increase your platelet count.

Prevention of ITP

The best way to prevent ITP is to be aware of what may cause it and to avoid coming into contact with potential triggers. Potential triggers of ITP include:

• Infections: Viral or bacterial infections may trigger ITP. It is important to get prompt treatment for infections.
• Medications: Certain medications may trigger ITP. Be sure to talk to your doctor about any medications you are taking.
• Malignancy: Certain types of cancer may increase your risk of ITP. Be sure to see your doctor regularly for cancer screening tests.