Idiopathic thrombocytopenic purpura (ITP) is a blood disorder that can be described as isolated low platelet count type of thrombocytopenia. It displays a normal bone marrow along with the absence of other causes of thrombocytopenia.
ITP can lead to excessive bruising and bleeding, resulting from the unusually low levels of platelets responsible for blood clotting. The disorder is also called immune thrombocytopenic purpura and affects both children and adults.
Children often develop it after a viral infection but recovers fully without treatment. In adults, the disorder is often chronic.
It will be a really horrible situation to experience sudden and uncontrolled gushing out of blood from the nose, gums and other openings of the body. And sadly, it could happen with a really low platelet count. Before that happens, better manage it immediately. This may usually be a costly endeavor but there are affordable options such as all-natural remedies you can learn from money back guaranteed materials like Conquer Low Platelets.
Idiopathic Thrombocytopenic Purpura
Treatment of idiopathic thrombocytopenic purpura depends on the symptoms, platelet count, and the age of the patient. If the patient exhibits no signs of bleeding and the platelet count is not very low, then treatment for idiopathic thrombocytopenic purpura is usually not necessary.
The aim in the treatment of ITP besides achieving normal and safe platelet count is to prevent bleeding complications while at the same time, minimize the side effects that are possibly associated with the treatment process.
Common ITP Treatment Methods
Adults experiencing mild cases of ITP only require regular monitoring of platelet levels. In cases of severe and troublesome symptoms, with the display of a very low platelet count, special treatment is advised.
ITP treatment may include intake of medications or surgical removal of the spleen referred to as splenectomy. It can also be as simple as discontinuation of certain drugs known to further inhibit platelet function. Examples of such drugs are ibuprofen, aspirin, and other blood-thinning medications like warfarin.
1. Removal of the spleen (splenectomy)
Surgical removal of the spleen (splenectomy) is an option in the treatment of severe ITP. The procedure eliminates the main source of platelet accumulation in the body, improving the platelet count. This procedure does not work for every ITP patient. Splenectomy for ITP is not as popular as it was.
Serious post-surgical complications may sometimes occur due to the permanent lack of the spleen which increases susceptibility of the patient to infections.
This is the first line of treatment for ITP where prednisone is usually used. The therapy aims at helping raise the blood platelet count by decreasing the activity of the body’s immune system. Once the platelet count is back to normal levels, the patient can gradually stop taking the drug under the doctor’s directions. This general treatment takes a period of about two to six consecutive weeks.
Adults with ITP may experience a relapse after discontinuing the use of corticosteroids. This leads to the need for a new course of corticosteroids.
Long-term use of the medication is not recommended due to the risk of serious side effects such as weight gain, increased risk of infection, cataracts, loss of calcium from bones, and high blood sugar.
3. Intravenous immunoglobulin (IVIG).
This is a treatment method for critical bleeding or when it is needed to quickly increase blood count before surgery. Drugs including immune globulin are given intravenously. They are quick and effective; with their effectiveness wearing off in a couple of weeks.
Side effects include headache, fever, and nausea. In some people, Rho (D) immune globulin (WinRho) will be used as it results in fewer side effects than IVIG.
4. Thrombopoietin receptor agonists.
These are the newest medications approved for the treatment of ITP. The ones used are romiplostim (Nplate) and eltrombopag (Promacta). The drugs help the bone marrow produce more platelets that help prevent bruising and excessive bleeding. However, there are possible side effects such as headaches, muscle pain, joint pains, dizziness, nausea, and increased risk of blood clots.
5. Biologic therapy.
When patients develop resistance to steroids and intravenous immunglobulins (IVIg), there are some biological treatment options that can be used. Biologic therapy commonly makes use of Rituximab (Rituxan) which helps reduce immune system response. This is applicable for people with severe ITP. Side effects include low blood pressure, sore throat, and rashes. Fever may also be experienced.
6. Emergency treatment.
Widespread or severe bleeding is dangerous and life-threatening that it calls for emergency care. Emergency treatment for ITP includes transfusions of blood platelet concentrates, intravenous immune globulin, and intravenous methylprednisolone – which is a type of corticosteroid.
7. Immunosuppressant drugs.
These are drugs that suppress the body’s immune system. They control the activity of the body’s immune system against platelets, reducing platelet destruction. Immunosuppressant drugs include cyclophosphamide and azathioprine. These drugs have been used to treat ITP despite having a number of significant side effects and effectiveness is not yet fully established.
Common side effects of immunosuppressants include fever, nausea and vomiting, low blood pressure, headache, hair loss, and dizziness.
8. H. pylori treatment.
In some cases, individuals with ITP are also infected with a bacterium that causes most of peptic ulcers – Helicobacter pylori. Elimination of the bacteria has helped increase platelet count return to normal in some patients. However, the results of therapy can be inconsistent making it necessary to be exploited further.
9. Thrombopoietin receptor agonists.
Thrombopoietin receptor agonists are pharmaceutical agents used to stimulate platelet production in the bone marrow. In this account will they differ with the previously discussed agents that focuses mostly on lessening the extent of platelet destruction. Available products under this class include Romiplostim and Eltrombopag.
10. Use of Rituximab.
The use of rituximab, which is a chimeric monoclonal antibody on the B cell antigen CD20, sometimes becomes an effective alternative treatment to surgery or splenectomy. However, the use of this treatment method brings significant side effects as previously mentioned.
Pregnant women suffering from ITP require special consideration during delivery to avoid complications on the baby and the mother. If the platelet count is more than 50 × 109/L (>50 × 103/µL), the perceived risk of serious hemorrhage is considerably low.
It is usually advised by doctors that oral prednisone is started a week before delivery as a reasonable precaution. In cases of platelet count that is less than 50 × 109/L (50 × 10 3/µL) just before delivery, treatment with the use of oral prednisone as well as IVIG is recommended. However, doctors advise the avoidance of using IV RhIG in such pregnancy situations until safety data is available.
Splenectomy is not a common method of treatment when dealing with pregnant cases, or neither is the treatment necessary to manage cases of acute hemorrhage.
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