Laboratory diagnosis of Idiopathic thrombocytopenic purpura (ITP)

 Laboratory diagnosis of Idiopathic thrombocytopenic purpura (ITP)

immune thrombocytopenic purpura

A condition in which platelets (blood cells that cause blood clots to form) are destroyed by the immune system. The low platelet count causes easy bruising and bleeding, which may be seen as purple areas in the skin, mucous membranes, and outer linings of organs. This disease is caused by an immune reaction against one's own platelets. It has also been called autoimmune thrombocytopenic purpura. Also called idiopathic thrombocytopenic purpura, immune thrombocytopenia, and ITP.

• Thrombocytopenia means a decreased number of platelets in the blood.
• Purpura refers to the purple discoloring of the skin, as with a bruise.

ITP is a fairly common blood disorder that both children and adults can develop.

There are two forms of ITP:

• Acute thrombocytopenic purpura. This usually affects young children, ages 2 to 6 years old. The symptoms may follow a viral illness, such as chickenpox. Acute ITP usually starts suddenly and the symptoms usually disappear in less than 6 months, often within a few weeks. Treatment is often not needed. The disorder usually does not recur. Acute ITP is the most common form of the disorder.
• Chronic thrombocytopenic purpura. The onset of the disorder can happen at any age, and the symptoms can last a minimum of 6 months, several years, or a lifetime. Adults have this form more often than children do, but it does affect adolescents. Females have it more often than males. Chronic ITP can recur often and requires continual follow-up care with a blood specialist (hematologist).

• Medical History

  Your doctor may ask about:

  • Your signs and symptoms of bleeding and any other signs or symptoms you're having
  • Whether you have illnesses that could lower your platelet count or cause bleeding
  • Medicines or any over-the-counter supplements or remedies you take that could cause bleeding or lower your platelet count

  Physical Exam

  During a physical exam, your doctor will look for signs of bleeding and infection. For example, your doctor may look for purplish areas on the skin or mucous membranes and pinpoint red spots on the skin. These are signs of bleeding under the skin.

• often than it affects men.

  What are the symptoms?

  ITP may not cause any symptoms. However, ITP can cause bleeding that is hard to stop. This bleeding can be inside your body, underneath your skin, or from your skin.

  Signs of bleeding may include:

  • Petechiae, which are small, flat red spots under the skin caused by blood leaking from blood vessels
  • Purpura, which is bleeding in your skin that can cause red, purple, or brownish- yellow spots
  • Clotted or partially clotted blood under your skin (called a hematoma) that looks or feels like a lump
  • Nosebleeds or bleeding from your gums
  • Blood in your urine or stool
  • Heavy menstrual bleeding
  • Extreme tiredness

How is idiopathic thrombocytopenic purpura diagnosed?

In addition to a complete medical history and physical exam.

• Laboratory Studies

  The workup for immune thrombocytopenia (ITP) starts with:
• Complete blood count (CBC). A measurement of size, number, and maturity of different blood cells in a specific volume of blood (to measure platelets).
• The hallmark of ITP is isolated thrombocytopenia; anemia  and/or neutropenia may indicate other diseases.
• • A blood smear. For this test, some of your blood is put on a slide. A microscope is used to look at your platelets and other blood cells. On peripheral blood smear, the morphology of red blood cells (RBCs) and leukocytes is normal. The morphology of platelets is typically normal, with varying numbers of large platelets.
• You also may have a blood test to check for the antibodies (proteins) that attack platelets.

• If blood tests show that your platelet count is low, your doctor may recommend more tests to confirm a diagnosis of ITP. For example, bone marrow tests can show whether your bone marrow is making enough platelets.

  If you're at risk for HIV, hepatitis C, or H. pylori, your doctor may screen you for these infections, which might be linked to ITP.

  Some people who have mild ITP have few or no signs of bleeding. They may be diagnosed only if a blood test done for another reason shows that they have low platelet counts.

• Bone marrow tests: These tests check whether your bone marrow is healthy. You may need this test to confirm that you have ITP and not another platelet disorder, especially if your treatment is not working.

• Additional blood and urine tests. These tests are done to measure bleeding time and detect possible infections, including a special blood test called an antiplatelet antibody test.

Key points about immune thrombocytopenic purpura

• Idiopathic thrombocytopenic purpura is a blood disorder characterized by an abnormal decrease in the number of platelets in the blood.
• A decrease in platelets can result in easy bruising, bleeding gums, and internal bleeding.
• ITP may be acute and resolve in less than 6 months, or chronic and last longer than 6 months.
• Treatment options include a variety of medications that can reduce the destruction of platelets or increase their production.
• In some cases, surgery to remove the spleen is necessary.

https://www.hopkinsmedicine.org/health/conditions-and-diseases/idiopathic-thrombocytopenic-purpura

https://www.nhlbi.nih.gov/health/immune-thrombocytopenia

https://www.mayoclinic.org/diseases-conditions/idiopathic-thrombocytopenic-purpura/symptoms-causes/syc-20352325#:~:text=Immune%20thrombocytopenia%20usually%20happens%20when,bacteria%20that%20causes%20stomach%20ulcers.

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