Causes And Risk Factors For Idiopathic Thrombocytopenic Purpura

Idiopathic thrombocytopenic purpura (ITP) is a rare condition described as the scarcity of platelets, which are responsible for producing blood clots that help prohibit bleeding. Low platelets can lead to abnormal bleeding and bruising. Bleeding can occur beneath or on the surface of the skin, or within the internal organs, and someone with ITP can find blood in their urine or stool.

Additional symptoms include bleeding from the nose or gums, and if patients see purple patches on their skin, it's due to bleeding underneath the skin. On the other hand, these spots can appear for no reason at all. Women with idiopathic thrombocytopenic purpura might experience heavier blood flow from cramping. ITP is more frequent in children than in adults. The condition counts for four to eight cases per 100,000 children.

Immune System Reaction

The condition is sometimes called immune thrombocytopenic purpura because it is closely linked to an autoimmune response from the immune system. The immune system reaction is characterized by the production of antibodies, which are formed to counteract infectious agents in the body; however, they end up attacking the platelets instead. This happens because the immune system senses the platelets as foreign, and then the platelets, coated by the antibodies, are eliminated from the blood by the spleen or liver. While it is uncommon for this to occur, a definite cause for the immune system acting in such a manner has yet to be discovered.

Breakdown Of Platelets

Several factors are known to cause the breakdown of platelets, and as mentioned, the immune system plays a role in the platelet reduction. The body destroying more platelets than necessary can cause a low platelet count. When platelets are formed, they circulate for up to ten days before being removed from the bloodstream so the body can make new ones. In some cases, low platelet count occurs as the result of an enlarged spleen, which actually occurs due to an excessive amount of platelets present in the spleen.

Some diseases, besides ITP, drugs, and medicines can lead to the breakdown of platelets. An example is thrombotic thrombocytopenic purpura, which happens when blood clots are formed in the body. Several diseases are known to cause a decrease in platelets, including rheumatoid arthritis, lupus, leukemia, Gaucher's disease, aplastic anemia, quinidine, cirrhosis, lymphoma, and myelodysplasia.

Gender

Gender is widely thought to be a risk factor for idiopathic thrombocytopenic purpura, and it has been estimated adult females are two to three times more likely than men to be affected. A study has demonstrated childhood ITP appears more frequently in males.

At least seven percent of pregnant women experience decreased levels of platelets. It typically does not affect the baby, but doctors have to be mindful that conditions such as HELLP syndrome and preeclampsia might be causing the low platelet count. Platelet levels usually return to normal following the baby’s birth. In some cases, a baby born to a woman with ITP will have low platelets in their blood. However, this can be treated. If an individual's platelet count is extremely low, the doctor might give them a transfusion.

Viral Infection

Idiopathic thrombocytopenic purpura can also occur following the aftermath of infectious agents in the body. This is most common in children ages two to six with an acute form of short-term idiopathic thrombocytopenic purpura. Symptoms of this form typically last for less than six months, and many children who have had acute ITP have recovered without treatment.

The child might experience a little bit of bleeding, so monitoring is necessary. The doctor could also prescribe corticosteroids or give the child intravenous immune globulin (IVIG) or anti-D immune globulin. Children can develop acute idiopathic thrombocytopenic purpura at least several days or weeks after the diagnosis of a viral infection. A child may be vulnerable to ITP if they have previously developed a condition such as hepatitis C, cytomegalovirus (CMV), human immunodeficiency virus (HIV), encephalomyocarditis virus (EMCV), Epstein-Barr virus, parvovirus, influenza, rubella, rotavirus, chickenpox, varicella-zoster virus, measles, or mumps. Hepatitis A and B are also regarded as risk factors.

Medications

Taking certain medications can put patients at risk of developing ITP. When this occurs, it is called drug-induced immune thrombocytopenia. Doctors can tell patients to stop taking a particular medicine if it's what causing their ITP and prescribe another one. Recovery from drug-induced immune thrombocytopenia can take one to two weeks after the patient has stopped taking the medication.

Quite a lot of medicines can cause ITP, including anti-inflammatory drugs, antidepressants, sulfa drugs, anticonvulsants, and antibiotics. These medicines may stimulate antibody production, which will likely cause platelets to be broken down abnormally. In addition, it is theorized the medication could simply destroy the platelets. Specific medications like this are quinine, dalteparin, diazepam, quinidine, sulfonamides, penicillin, heparin, captopril, gold salts, digoxin, tolmetin, and famotidine. Heparin is what causes most cases of drug-induced idiopathic thrombocytopenic purpura.