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Tests and diagnosis
By Mayo Clinic staffDoctors usually diagnose idiopathic thrombocytopenic purpura by excluding other possible causes of bleeding and a low platelet count, such as an underlying illness or medications you may be taking. If no other underlying problem is causing your signs and symptoms, then a diagnosis of ITP may be made.
In addition to taking your medical history and performing a physical exam, your doctor may order the following tests when checking for ITP:
- Complete blood count. This common blood test is used to determine the number of white and red blood cells and platelets in a sample of your blood. With ITP, white and red blood cell counts are usually normal, but the platelet count is low.
- Blood smear. A sample of your blood is placed on a slide and observed under a microscope. This test is often used to confirm the number of platelets observed in a complete blood count.
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Bone marrow examination. Another test that may help identify the cause of a low platelet count is a bone marrow exam. Platelets are produced in your bone marrow — soft, spongy tissue in the center of your large bones. In some cases, a sample of solid bone marrow is removed in a procedure called a bone marrow biopsy. Or, you may have a bone marrow aspiration, which removes the liquid portion of your marrow. In many cases, both procedures are performed at the same time (bone marrow exam). Both the liquid and solid bone marrow samples are frequently taken from the same place on the back of one of your hipbones. A needle is inserted into the bone through an incision.
If you have ITP, your bone marrow will be normal because your low platelet count is caused by the destruction of platelets in your bloodstream and spleen — not by a problem with the bone marrow.
- 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.
