Are you constantly bruising? Are you bleeding? This could be ITP (Immune Thrombocytopenia)

Have you ever noticed a bruise or two all of a sudden on your body and thought, "Wow, where did this hit?" It's normal to get minor bruises like that sometimes. But if you're getting bruises all over your body for no reason, if your gums bleed when you brush your teeth, or if even a small scratch doesn't stop bleeding, it's something to be concerned about. Today we're talking about a condition that causes similar symptoms, but many people don't know about it. That's ITP.

Simply put, what is ITP?

The full name of the disease, abbreviated as ITP, is Immune Thrombocytopenia. This is a very rare blood-related condition.

Think about it, there are very small cell parts called ``Platelets`` in our blood. They're like little soldiers in our bodies. If there's a cut or injury somewhere, the main job of these platelets is to rush there, stick together, and stop the bleeding.

Now, here's what happens to someone with ITP. The immune system, which protects our body from disease, suddenly goes haywire. Because of that mess, the immune system mistakenly identifies our own good 'soldiers', the platelets, as an enemy from outside. Then, because of that false signal, the immune system starts destroying these platelets.

When platelets decrease, their ability to stop bleeding also decreases. That's why you start to bruise and bleed unnecessarily.

What are the main types of ITP?

ITP is divided into three main types, depending on how long it lasts. It is very important for you to know this.

What are the symptoms of ITP?

Symptoms only become apparent when platelet counts are very low. Some people may not have any symptoms at first.

• Sudden bruising: Sudden, blue-purple bruises appear without any trauma to the body.
• Red spots on the skin: Red-purple spots (`petechiae`) that look like tiny pinpricks, especially on the lower legs. These are actually blood leaking from the tiny blood vessels under the skin.
• Large spots: Sometimes large red, purple, or brown spots (`Purpura`) appear.
• Bleeding gums: Your gums can bleed, both when brushing your teeth and when you just stand there.
• Nosebleed: Once a nosebleed starts, it can be difficult to stop.
• Blood in the urine or stool: This is a slightly more serious symptom.
• Heavy menstrual bleeding in women: Menstruation lasting more than 7 days and heavy bleeding.
• Unusual fatigue: Excessive tiredness and fatigue felt for no reason.

What are the causes of ITP?

As we discussed earlier, the main cause of ITP is a problem with the immune system. However, ITP can be divided into two types depending on why this problem occurs.

1. Primary ITP: In this type of ITP, there is no clear external cause. The immune system simply malfunctions.

2. Secondary ITP: In this case, ITP occurs due to another medical condition or infection. For example:

• Viral infections like `HIV` or `Hepatitis C`.
• Bacterial infections like `H. pylori`.
• Other autoimmune diseases like lupus.
• This condition can also be caused by some medications.

Diagnosis and treatment

If you have these symptoms, the first thing you should definitely do is see a doctor for advice. Don't be afraid. The doctor will ask you about your medical history and examine your body.

Then, they will order some tests to see if there are other causes for these symptoms.

• Full Blood Count (FBC/CBC): This is what tells you exactly how low your platelet count is.
• Peripheral Blood Smear: In this, a drop of blood is taken and examined under a microscope to check the nature of the platelets.
• Other tests: You may also be tested for infections such as HIV and Hepatitis C.

How is it treated?

Not everyone with ITP will start treatment right away. Your doctor will decide whether to start treatment or not based on your platelet count, the severity of your symptoms, and your risk of bleeding.

If treatment is needed, there are several main treatments that are given:

• Corticosteroids: These are the first type of medication given. These medications work by controlling the immune system's activity and stopping the destruction of platelets.
• Intravenous Immunoglobulin (IVIG): This is a treatment given through a vein (like a saline solution). If there is heavy bleeding, it can help increase your platelet count quickly.
• Platelet Transfusion: In the event of serious, life-threatening bleeding (for example, a brain bleed), platelets from a healthy person are given as an emergency.
• Other medications: If the initial treatment does not control the disease, medications that increase platelet production (such as `Eltrombopag`, `Romiplostim`) or that control the immune system in other ways (such as `Rituximab`) are given.
• Splenectomy: The spleen is a major site of platelet destruction in our body. If the disease cannot be controlled with medication, doctors recommend surgical removal of the spleen for some people.

Things to consider when living with ITP

Chronic ITP is a condition that can be with you for a long time. Therefore, you need to take care of the little things to protect yourself from accidents and bleeding while living a normal life.

• Be safe: Avoid contact sports like rugby and football. If you ride a bike, be sure to wear a helmet.
• Use a soft toothbrush: This helps prevent gum injury.
• Be careful when using sharp objects: Think twice when using things like knives and nail clippers.
• Reduce stress: It is very important to relax your mind through things like yoga and meditation.

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