3 important insights about immune thrombocytopenia

 Immune thrombocytopenia (ITP) is a disease caused by the destruction of platelets or thrombocytes by the immune system itself. It is therefore an autoimmune disease.

There are different levels of severity and symptoms of ITP depending on the platelet count. The disease is characterised by an increased risk of bleeding. Platelet levels of between 150,000 and 400,000 per microlitre are considered normal.

When these levels decrease temporarily or persistently, without known triggering factors, then we speak of primary ITP. If the platelet count is below these levels, but above 50,000, it is normally asymptomatic and does not cause bleeding. In these cases, the disease will be difficult to diagnose.

If the platelet count is between 30,000 - 50,000, small hemorrhages often occur when there is trauma, blow, etc. If the count is between 10,000 - 30,000, petechiae, metrorrhagia, epistaxis, gingivorrhagia, etc. may occur spontaneously.

In this situation we speak of moderate thrombocytopenia. If the levels fall below 10,000 platelets per microliter, we are dealing with severe thrombocytopenia in which internal bleeding can occur in vital organs with serious consequences.

The origin of primary immune thrombocytopenia is unknown; although there are other forms of secondary thrombocytopenia associated with certain diseases, infections or the taking of certain medications.

Why does immune thrombocytopenia occur?

The decrease in platelet levels is due both to an increased destruction of platelets in the blood and to a defect in their production in the bone marrow. People who suffer from this disease possess certain antibodies, usually of the IgG type (although in some cases IgM and IgA are also involved), which are capable of recognizing certain proteins on the surface of these cells and marking them as if they were foreign elements to the body itself (antigens).

Consequently, platelets and their precursors in the bone marrow are recognized and eliminated by cells of the immune system, such as macrophages.

What precautions should a person with TPI take?

Physical activity should be controlled and free of dangers such as risky or contact sports, which can cause trauma. It is advisable to ask the doctor which activities should be avoided according to the person's lifestyle.

There are medications that can alter platelet activity, which is why it is always a good idea to ask your doctor before taking any medication.

Keeping the immune system in good condition is important to ensure that its response is balanced and that hypo and hyperactivity situations do not occur. In this regard, microimmunotherapy can be a support within a global strategy for treating immune diseases.

Bibliography

1. Karam D. Echevarría S. Diagnosis and treatment of immune thrombocytopenic purpura. Clinical practice guide. Mexican Social Security Institute.
2. Mayo Clinic. Idiopathic thrombocytopenic purpura. Patient Care and Health Information. Diseases & Conditions. Available at: https://www.mayoclinic.org/diseases-conditions/idiopathic-thrombocytopenic-purpura/symptoms-causes/syc-20352325.