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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
- Increased risk of infection
- High blood sugar, even diabetes
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 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 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.
- Idiopathic thrombocytopenic purpura (ITP). The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec11/ch133/ch133d.html. Accessed Aug. 28, 2010.
- Diz-Kucukkaya R, et al. Thrombocytopenia. In: Lichtman MA, et al. Williams Hematology. 8th ed. New York, N.Y.: McGraw-Hill Companies, Inc.; 2010. http://www.accessmedicine.com/content.aspx?aID=6238643. Accessed Aug. 28, 2010.
- What is idiopathic thrombocytopenic purpura? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/dci/Diseases/Itp/ITP_All.html. Accessed Aug. 27, 2010.
- George JN. Treatment and prognosis of immune (idiopathic) thrombocytopenic purpura in adults. http://www.uptodate.com/home/index.html. Accessed Aug. 27, 2010.
- Blanchette V, et al. Childhood immune thrombocytopenic purpura: Diagnosis and management. Hematology/Oncology Clinics of North America. 2010;24:249.
- 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.
- Anderson CF (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 29, 2010.
- Nplate (prescribing information). Thousand Oaks, Calif.: Amgen; 2008. http://www.nplate.com/patient/pdf/nplate_pi.pdf. Accessed Sept. 7, 2010.
- Promacta (prescribing information). Research Triangle Park, N.C.: Glaxo SmithKline; 2010. http://us.gsk.com/products/assets/us_promacta.pdf. Accessed Sept. 7, 2010.
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