• Immune Thrombocytopenia (ITP) Overview

    Immune thrombocytopenia (ITP), sometimes also called immune thrombocytopenic purpura or idiopathic thrombocytopenic purpura, is an autoimmune disorder that occurs when the body destroys platelets too quickly. Platelets are the part of blood that helps control bleeding.

    In healthy children, the body produces proteins called antibodies that guard against infection. ITP causes the body to make abnormal antibodies that stick to platelets, which the spleen (the organ that helps filter infections in the blood) recognizes as foreign and destroys. Rather than living the normal seven to 10 days, platelets survive only for a few hours in a child with ITP. A viral infection may trigger ITP because antibodies the body develops to fight infection can also attack platelets.

    Pediatric ITP Treatment at Dana-Farber/Boston Children's

    Children with immune thrombocytopenia (ITP) are treated through the Platelet Function Disorders Program at Dana-Farber/Boston Children's Cancer and Blood Disorders Center. Continue reading to learn more about ITP or visit the Platelet Function Disorders Program to learn about our expertise and treatment options for this condition.

    Symptoms & Diagnosis

    Acute immune thrombocytopenia (ITP), which accounts for more than 90 percent of cases, occurs between the ages of 2 and 6, with sudden onset of symptoms. These symptoms usually resolve in less than six months, often within a few weeks. With chronic ITP, which is more common in adults, symptoms last a minimum of six months and can persist for years, requiring regular follow-up with a hematologist (a doctor who specializes in blood disorders). Symptoms of ITP include:

    • Purpura – a purplish coloring of the skin after blood has leaked under it, forming a bruise
    • Petechiae – tiny red dots under the skin that are a result of very small bleeds into the skin
    • Nosebleeds
    • Bleeding from the mouth
    • Blood in vomit, urine and stool

    In rare cases, life-threatening bleeding inside the brain can result from head trauma.

    Doctors diagnose ITP with:

    • A careful medical history and physical examination
    • Complete blood count, including a hematologic examination under a microscope

    A bone marrow biopsy usually is not necessary. After all tests are completed, doctors will be able to outline the best treatment options.

    Treatment & Care Options

    There are a number of treatments to increase platelets, but there is no cure for immune thrombocytopenia (ITP). Specific treatment is not always necessary, but the most common are:

    • Steroids – to temporarily reduce production of antibodies and increase platelet count by slowing the rate at which the spleen destroys them
    • Intravenous gamma globulin – a human blood product containing antibodies that help slow the rate at which abnormal platelets are destroyed by the spleen
    • Intravenous Rh immune globulin – a human plasma product that temporarily stops the spleen from destroying platelets; children must be blood type Rh positive and still have their spleen to receive this treatment.

    Other treatments include surgery to remove the spleen (considered for older children with chronic ITP), hormone therapy (for teenage girls to stop their menstrual cycle if excessive bleeding occurs), and antibiotics to treat infections.

    Progressive or Recurrent Disease

    Recurrence of ITP is uncommon, but can occur up to several years after the initial episode and may be associated with another viral infection.

    Long-term Outlook

    More than 80 percent of children with treated ITP recover spontaneously in days, weeks or months. Fatal brain hemorrhages rarely occur with steroid, intravenous RH immune globulin, or intravenous gamma globulin therapy.
  • Contact Us

    Our specialized new patient coordinators can answer your questions about treatment options and becoming a patient.
  • Find Clinical Trials

    We sponsor and collaborate on clinical trials that break new ground in pediatric cancer and blood disorder treatment. callout bg
  • Treating Blood Disorders

    Dana-Farber/Boston Children's patients with blood disorders have access to a variety of treatment options, including blood transfusions, surgery, advanced new medications and stem cell transplant.