What It Means To Be Diagnosed With ITP- An Autoimmune Disorder

Immune thrombocytopenia (ITP) is a debilitating autoimmune illness characterized by accelerated platelet destruction and blood platelet decrease, leading to bleeding risk.

A healthy platelet count ranges between 150,000 to 450,000. The platelet count is fewer than 100,000 in ITP. You may have a platelet count of less than 10,000 by the time serious bleeding occurs. The lesser the platelet count, the more likely you are to hemorrhage.

Chronic refractory ITP patients are those who fail to maintain a normal platelet count despite conventional therapy.

What are the symptoms of ITP?

There may be no signs or symptoms of immune thrombocytopenia. When they do happen, they may involve the following:

• Tiny purplish/reddish dots under the skin (blood cots)
• Nosebleeds
• Bleeding in the mouth, in and around the gums
• Heavy menstrual periods
• Blood in the vomit, urine, or stool

A worst-case scenario will cause bleeding in the head.

What Causes ITP?

Immune thrombocytopenia occurs when your immune system mistakenly assaults and destroys platelets, which are blood-clotting cell fragments.

According to Mayo Clinic, infection with HIV, hepatitis, or H. pylori, the bacteria that causes stomach ulcers, can cause ITP in adults. It is particularly common in children who have had a viral disease like the mumps or the flu.

Diagnosis Of ITP

To diagnose ITP, A physician will take you through these tests in addition to a comprehensive medical history and physical examination:

1. a full blood count (CBC). The size, number, and maturity of various blood cells in a certain amount of blood (test platelets).
2. Additional blood and urine tests. These tests, including an antiplatelet antibody test, are used to determine the bleeding time and detect potential infections.
3. An aspiration of the bone marrow may be conducted to screen for any aberrant cells produced by the marrow that could cause platelet counts to decline.
4. A thorough examination of your drugs is required.

Treatment of ITP

Treatment of ITP depends on your age, the extent of disease, tolerance on some medications and much more. When emergency treatment is required, the two most popular options are steroids and intravenous gamma globulin.

Steroids reduce platelet degradation, which helps to minimize bleeding. Steroids, if effective, will result in a 2 to 3-week increase in platelet counts. Irritability, stomach irritation, weight gain, high blood pressure, and acne are possible side effects.

Intravenous gamma globulin (IVGG) is a protein given intravenously and contains many antibodies, and inhibits platelet degradation. IVGG is more effective than steroids in terms of speed (within 24 to 48 hours).

Treatment for an infection. If ITP is caused by infection, treating the infection may increase platelet counts.

Splenectomy. Because the spleen is the most active site of antibody-mediated platelet destruction, it may be necessary to have it removed in some circumstances. This is more commonly considered in persons with chronic ITP to slow platelet breakdown.

Platelet transfusions. This may be required for those who are bleeding profusely or who will have surgery.

Immune globulin Rh. This drug prevents the spleen from degrading platelets for a short time. This drug will only work if you are Rh-positive and have a spleen.

Rituximab. This type of antibody is used to treat cancer (Rituxan). This drug is an antibody made in a lab against a protein found on antibody-producing blood cells. Antiplatelet antibody production is slowed.

Eltrombopag (Promacta) and romiplostim (N-plate). These drugs were recently approved for the treatment of ITP in patients who had previously failed to respond to other treatments. They encourage the production of more platelets in the bone marrow.

Changes in your medication or lifestyle. If medicine is thought to be the reason, it may be essential to stop or change the prescription. Lifestyle, on the other hand, can include things like wearing protective gear and avoiding specific activities.

My Personal Experience With Someone Living With ITP

My mother was diagnosed with ITP when she was in her early forties. She had petechiae on her hands, thighs, and legs for a while. At first, it was not alarming until we realized the spots were not disappearing. It was also accompanied by bleeding gums, blood blisters on the tongue and rashes.

So one evening, after she alighted at the bus stop and bruised her left toe, we realized it was time to visit the doctor. What intrigued us was that, after an hour, the bleeding from her injured toe did not stop. It was a small bruise, yet the bleeding was continuous; in other words, the blood clotting process did not occur.

The doctor on the phone tells us, ‘That is an emergency, stop whatever you are doing and visit the nearest Hospital.’

On arrival at the hospital, the doctors did blood works on her plus a bone marrow aspiration, and we were immediately informed she needed a platelet transfusion because it was less than 3000, a value considered too low.

She recovered through the transfusions until ITP was at the doorstep again a year later. Luckily she survived again through platelet transfusion but needed to take medications for a long time. Along with the adverse effects of prednisone, anxiety, weariness, and despair became a part of her daily existence.

When her body stopped responding to the medication, she hit rock bottom, and in the third year, ITP presented itself so severely that even the blood count itself dropped, i.e. it was not only a lack of platelets but of blood as a whole as well.

Her body became unresponsive to transfusion, and the doctors discouraged a splenectomy for some other reasons. Therefore, they suggested one more solution; using a drug known as Rituximab. It was administered in four doses, one injection each week for four weeks. Fortunately, she recovered again.

Now she is 46 and healthy but has to be cautious about many things, including the lifestyle, medications, Covid-19 Vaccine and food.

TakeAway

It’s critical to recognize that many people with ITP and other chronic illnesses suffer from anxiety and despair. They will experience bad days in terms of their physical and mental wellbeing.

Therefore, show empathy, love, validation, compassion and understanding. Attend their doctor’s appointments and offer your support for the patient’s experience. With them, you can work out to stay fit. By their side, prepare nutritious meals and assist with cleanup!. Attend disease awareness events with them.