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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 used for chronic or severe ITP. Corticosteroids are a first line treatment because they help dampen the immune system attack on the platelets. But, long-term use of corticosteroids can cause serious side effects, including bone loss (osteoporosis), cataracts and high blood sugar levels, possibly leading to type 2 diabetes.
Removal of your spleen (splenectomy), which may be performed if corticosteroids aren't working, helps prevent the loss of platelets. However, removing the spleen also makes you permanently more vulnerable to infection. Fortunately, the risk of an overwhelming infection in a healthy person who has had a splenectomy is low.
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, because your baby's platelet count may drop before it starts to rise. It's likely that your baby's platelet count will improve without treatment, but if the count is very low, treatment can help the baby recover faster.
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.
- What is idiopathic thrombocytopenic purpura? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/itp/printall-index.html. Accessed Feb. 25, 2013.
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Feb. 25, 2013.
- Tintinalli JE, et al. Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. New York, N.Y.: The McGraw Hill Companies; 2011. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=40. Accessed Feb. 25, 2013.
- Stone CK, et al. Current Diagnosis & Treatment Emergency Medicine. 7th ed. New York, N.Y.: The McGraw Hill Companies; 2011. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=718. Accessed Feb. 25, 2013.
- Guide to understanding ITP (immune thrombocytopenia). ITP Foundation. http://www.itpfoundation.org/itpdefined.htm. Accessed Feb. 25, 2013.
- Arnold DM. Positioning new treatments in the management of immune thrombocytopenia. Pediatric Blood & Cancer. 2013;60:S19.
- Idiopathic thrombocytopenic purpura (ITP). The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/print/hematology_and_oncology/thrombocytopenia_and_platelet_dysfunction/immune_thrombocytopenic_purpura_itp.html. Accessed Feb. 25, 2013.
- Bussel JB. Traditional and new approaches to the management of immune thrombocytopenia: Issues of when and who to treat. Hematology/Oncology Clinics of North America. 2009;23:1329.
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