Presentation on
ITP
By James Runco
“Everyone bleeds sometimes,
I just bleed more.”
ITP
ITP stands for
Idiopathic Thrombocytopenic Purpura
but it is also frequently called:
Immune Thrombocytopenic Purpura or
Idiopathic Thrombocytopenia
Background Information
There are three Basic types of blood cells
made in the marrow of the bones each
with their own specialized jobs.
Red Blood Cells (Rbc’s) Carry Oxygen
White Blood Cells (Wbc’s) Protect your body from infection
Platelets (Plt’s) Help your help your body to heal injuries
This is a Picture of Normal Blood
Cells
What ITP does.
ITP is an autoimmune disease during which your
body’s immune system attacks and destroys
your platelets.
The body releases auto-antibodies which
chemically tag its’ own cells as foreign
White blood cells then seek out and destroy
platelets as if they were fighting an infection
This causes a rapid drop in the level of platelets in
a person’s body
More about ITP
This Thrombocytopenia (lowered platelet level) is
Idiopathic, (without known cause) and can be
triggered at any time.
Platelets are a specialized form of blood cells that
are absolutely essential for your blood to clot.
When they are attacked by the White Blood cells it
can be disastrous.
Your body is left unable to mend any cuts or stop
bleeding even from the smallest internal injuries
Symptoms of ITP
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Excessive bleeding with
minor injuries
Spontaneous bleeding from
the mouth and nose
Unexplainable or
spontaneous bruising
Excessive internal bleeding
Disturbed sleep cycle/
Insomnia
Irregular appetite
Depression
Depression and ITP
ITP is accompanied by short term or more
permanent depression.
This is because 2% of the body’s serotonin
is stored in the platelets; when the
platelets are destroyed so is this mood
elevating neurotransmitter.
Platelets also carry Serotonin’s “parent”
chemical called L-Tryptophan
Depression and ITP Continued
This L-Tryptophan is able to pass through
the blood brain barrier, so it’s loss is the
probable cause of the sleep/ eating
irregularities.
This is Jane
Normal Platelet Counts
Thrombocytopenic Platelet Counts
This is Jane with ITP
Causes
The exact causes of ITP are as yet unknown, but
there is currently research going on to try and
determine what causes this disease.
There are many theories, most state that ITP is a
multifactorial disease with a strong genetic
predisposition.
Researchers are currently looking for multiple
instances of ITP in a family, and have found that
in some cases ITP can be passed from mother
to child.
Moms and ITP
There seems to be a
connection between ITP
and pregnancy. A
previously normal woman
can sometimes develop
ITP during a pregnancy.
Pregnancies are much more
dangerous for women
with ITP, both because
their platelet counts can
drop and because of the
bleeding involved with
delivery.
Theories
Three most common theories for ITP are:
 The Microbial Trigger Theory
 The Molecular Mimicry Theory and
 The Free Radical Damage Theory
The Microbial Trigger Theory
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Links the destruction of platelets to a chemical
called interleuken 12 that is released when the
body is fighting a bacterial infection
They believe that in some people this
interleuken 12 can inadvertently activate
dormant self reactive cells that then convince
your body that a cell near the bacteria is also
part of the infection
If that cell is a specialized platelet then you
would develop ITP
The Molecular Mimicry Theory
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This theory says that someone can develop ITP
when the bodies T helper cells recognize a viral
or bacteria amino acid sequence that happens
to occur on the surface of a platelet
Normally T helpers that would target somatic
cells are inhibited by other immune agents.
If there is a malfunction in the production of
these inhibiting agents then the self reactive T
helper cells are free to target platelets for
destruction
Free Radical Damage Theory
DNA is damaged by “free radicals”
 Free radicals are compounds that build up
in the body, which need electrons in order
to become stable
 If they steal these electrons from DNA they
can cause mutations which could effect
the immunes system, and possibly trigger
ITP or other Autoimmune diseases.
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Diagnosis
ITP is often the Diagnosed by its’ symptoms. It is
frequently the diagnosis when all other blood
diseases are ruled out and there seems to be
the body mounting an attack against the
platelets
There are different forms of ITP. Some children
experience a disease which is listed as ITP
because it is thrombocytopenia with an unknown
origin. However it differs from adult and chronic
childhood ITP because many of these childhood
cases last only a matter of months and then go
into permanent remission.
ITP Statistics
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“Approximately 200,000
people in the US have
ITP”
In Adults women are
three times more likely to
have ITP than men, but in
children the statistics are
fairly even
“The percentage rate of
ITP cases is increasing.
Each year there are
approximately 20,000
new cases or about 10 to
125 per million people.”
3
2.5
2
Men
Women
1.5
1
0.5
0
Adults
Children
Treatment
In most cases ITP is not fatal and can be treated.
There is a wide variety of treatment options, but with only
partial success due to the unknown nature of the
disease.
The most commonly excepted, and most successful
treatments for ITP involve the removal of the spleen
because it is a site for autoantibody production.
People are also very commonly given Prednisone which is
an artificial steroid which can enhance platelet
production
For emergency case treatment (normally when platelets get
below 20,000) They will administer IV G or intravenous
gammaglobulin for several days, and they wait for counts
to rebound
Sources
Platelet Disorder Support Association
www.ITPpeople.com
Scripps Institute website
http://seconde.scripps.edu/ltp
Family Genetics.net
www.familygenetics.net