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Complications
By Mayo Clinic staffThe biggest risk associated with idiopathic thrombocytopenic purpura is bleeding, especially bleeding into the brain (intracranial hemorrhage), which can be fatal. Major bleeding is rare with ITP, however. Complications are more likely to arise from the treatments — corticosteroids and surgery — used for chronic or severe ITP. In fact, many therapies pose more serious potential risks than does the disease.
Long-term use of corticosteroids can cause serious side effects, including osteoporosis, cataracts, loss of muscle mass and increased risk of infection. Removal of your spleen (splenectomy), which may be performed if corticosteroids aren't working, also makes you permanently more vulnerable to infection, although the risk of an overwhelming infection in a healthy person who has had a splenectomy is small.
Pregnancy
Pregnant women with mild ITP usually have a normal pregnancy and delivery, though antibodies to platelets can cross the placenta and affect the baby's platelet count. In some cases, a baby may be born with a low number of platelets. If this happens, your baby's doctor will want to monitor your child for several days. It's likely that your baby's platelet count will improve without treatment, but if the count is very low, treatment can help speed recovery.
If you're pregnant and your platelet count is very low or you have bleeding, you have a greater risk of heavy bleeding during delivery. In such cases, you and your doctor may discuss treatment to maintain a stable platelet count, taking into account the effects on your baby.
- ITP: Idiopathic thrombocytopenic purpura. American Academy of Family Physicians. http://familydoctor.org/online/famdocen/home/common/blood/113.html. Accessed July 31, 2008.
- What is idiopathic thrombocytopenic purpura? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/Itp/ITP_WhatIs.html. Accessed July 31, 2008.
- George JN. Treatment and prognosis of idiopathic thrombocytopenic purpura in adults. http://www.uptodate.com/home/index.html. Accessed July 31, 2008.
- Rodeghiero F. Idiopathic thrombocytopenic purpura: An old disease revisited in the era of evidence-based medicine. Haematologica. 2003; 88(10):1081-1087.
- Stasi R, et al. Management of immune thrombocytopenic purpura in adults. Mayo Clinic Proceedings. 2004;79(4):504-522. http://www.mayoclinicproceedings.com/pdf%2F7904%2F7904r.pdf.
- Bussel JB, et al. Eltrombopag for the treatment of chronic idiopathic thrombocytopenic purpura. New England Journal of Medicine. 2007;357(22):2237-2247. http://content.nejm.org/cgi/content/abstract/357/22/2237. Accessed July 31, 2008.
- Rodeghiero F. First-line therapies for immune thrombocytopenic purpura: Re-evaluating the need to treat. European Journal of Haematology. 2008; 80(69)(suppl):19-26.
- Newland A. Emerging strategies to treat chronic immune thrombocytopenic purpura. European Journal of Haematology. 2008;80(69)(suppl):27-33.
