Idiopathic thrombocytopenic purpura (ITP)

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Blood cells

Immune thrombocytopenic purpura; ITP

In children, the disease often runs its course without treatment.

In adults, the initial treatment is usually with a drug called prednisone. A splenectomy (removal of the spleen) is sometimes advised. The spleen is the major site of platelet destruction, but removal of the spleen will only bring up the platelet count in 50% of people.

When the disease does not respond to initial treatment, other treatments are:

• Oral danazol (Danocrine)
• High-dose gamma globulin (an immune factor) injections
• Drugs that suppress the immune system
• Passing the blood over a protein A column (Prosorba) , which filters antibodies out of the blood stream
• Anti-RhD therapy can also be useful in people with specific blood types

People with ITP should avoid taking aspirin, ibuprofen, and warfarin because these drugs interfere with platelet function and blood clotting, and bleeding may occur.

The chance of remission (a symptom-free period) is good with prednisone or a splenectomy. Rarely, ITP may become a chronic ailment in adults and reappear, even after remission.

• Severe bleeding
• Bleeding into the brain or loss of blood into the digestive tract

Go to the emergency room or call the local emergency number (such as 911) if severe bleeding occurs, or if other new symptoms develop.

Review Date: 10/30/2006
Reviewed By: William Matsui, MD, Assistant Professor of Oncology, Division of Hematologic Malignancies, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD. Review provided by VeriMed Healthcare Network.