It occurs as a result of the red blood cells in the veins protruding into the subcutaneous tissues. Generally, trauma, injuries, infections, inflammatory changes, conditions that disrupt the integrity of tissues cause purpura without any problem in the blood coagulation system.
What is Purpura and Ecchymosis?
Purpura: Needle observed under the skin Bleeding larger than the tip size is called purpura. It occurs as a result of the red blood cells in the vein reaching the subcutaneous tissues.
Generally, trauma, injuries, infections, inflammatory changes, conditions that disrupt the integrity of the tissues cause purpura without any problem in the blood coagulation system.
Ecchymosis: Bleeding larger than 1 cm observed under the skin is called ecchymosis.
Idiopathic Thrombocytopenic Purpura (ITP)
ITP “Idiopathic Thrombocytopenic Purpura” causes an unknown decrease in platelet count and as a result means bleeding in the body. There are two types of ITP; Acute (short-occurring) Chronic (long-lasting) Acute ITP usually lasts less than 6 months and is generally seen in children, equally in both sexes. Chronic ITP is the form that is seen 2-3 times more often in adults and women than men. In many children, ITP is extremely mild and does not recur, lasting several weeks or months. Most of the time, the platelet count returns to normal in 8-12 months without even the need for treatment. In 5% of children, the disease is resistant to treatment. In adults, the disease usually lasts longer. In fact, cases where the disease lasts for years have been reported.
What is the Cause of ITP?
ITP is an auto-immune disease. In auto-immune diseases, our body accepts its own cells and tissues as foreign cells and tries to destroy them. In ITP, our body considers its own platelets as foreign. Platelets are normally produced in the bone marrow, but then coated with antibodies in the blood and broken down in the spleen. Infection may trigger the formation of ITP in children.
What are the Symptoms of ITP Disease?
Patients have bleeding. Bleeding inside or outside the body; can occur under the skin and subcutaneously. Bleeding on the skin, petechiae or purpura may occur in conjunction. Petechiae are small red or purple spots on your skin. Purpura is purple, brown, and red bruises. External bleeding in patients may also be in the form of nosebleeds, bleeding gums while brushing teeth, abnormal menstrual bleeding, bleeding from a cut site for a long time.
Blood in the urine or stool or bleeding from the anus are also common symptoms. ITP can show symptoms suddenly, or it can occur over time. Mild ITP is often asymptomatic. Low platelet count is noticed during routine blood test. Severe thrombocytopenia can cause bleeding almost anywhere in the body. This picture requires urgent treatment.
How is the Treatment of ITP Disease?
The treatment of the disease varies from person to person. Some cases are only followed up if the platelet counts are not very low. In general, the first choice in treatment is drug therapy. Steroids are often preferred in drug treatment.
Prednisone is the most commonly used drug among steroids. Because of the side effects of steroids, it is inconvenient to use them for a long time. This situation is taken into consideration in the treatment. Splenectomy is performed in resistant patients with side effects. Removal of the spleen does not cause much harm to the adult. The person may become susceptible to some infections, in this case, patients should be vaccinated against especially encapsulated microorganisms (Hemophilus, pneumococci and meningococci) before the spleen removal operation
Platelets can be given to patients with emergency bleeding or before splenectomy. One of the basic treatment parameters in patients with ITP is to regulate their lifestyle. Since the platelet count is low, these patients are prone to bleeding. It is necessary to avoid activities and sports that are open to trauma. Sports such as football, boxing, skiing and horse riding can be given as examples of traumatic activities. The most feared in these activities; are head traumas, and a patient with ITP can easily have a brain hemorrhage after trauma. Instead of such activities, the patient can do safer activities such as walking and cycling.
Read: 18
