Immune thrombocytopenia (ITP) is a condition that reduces the level of platelets in the body, which slows down the blood clotting process. This causes excessive bruising and bleeding, even without noticeable injuries. The condition can be acute (typically in children) or chronic (persistent). While acute ITP goes away on its own, the chronic form needs to be managed. It is important to recognize the causes and signs of the disease t o seek timely treatment .

Warning signs
1. Tiny spots of bleeding
A telltale sign of immune thrombocytopenia is petechiae, which are pinpoint-sized spots of bleeding under the skin or mucous membranes. This can be an early sign of ITP disease, typically developing inside the eyelids and on the arms, legs, mouth, and stomach. The spots could be red, brown, or purple, but unlike rashes, they are not raised, itchy patches of skin. So, it is important to avoid mistaking them for allergy-induced rashes and consult a doctor immediately.

2. Purpura
ITP-induced petechiae can come together to form larger purple, brown, or red blood spots on the skin. Known as purpura, these spots develop when tiny blood vessels leak under the skin’s surface. Although purpura typically consists of smaller dots that form a cluster in a specific area, they may look like large patches. This symptom may also develop in the mucus membranes, such as the throat or mouth.

3. Bruises
When blood pools under the skin, usually due to a blood vessel breaking, bruises develop. Here, one may not notice any external bleeding unless the skin breaks open. Bruises create marks, which could be brown, purple, black, or yellow. The bruising is often a result of a fall, sports or other injuries, or accidents. If bruises seem to develop more frequently than usual, they could be symptoms of ITP disease. This is among the most common signs of the condition. So, unexplained bruising should prompt one to get their platelet levels checked.

4. Bleeding gums
One may notice blood on their toothbrush or swelling in the gums. This issue may have various causes, such as poor oral hygiene, gingivitis, and trench mouth. It may develop due to persistent grinding of teeth or dental injuries. That said, bleeding gums are also a common warning sign of ITP. As the condition is associated with a lack of platelets, the gums can bleed easily with even slight abrasion. If one notices this issue frequently without any noticeable cause, one must consult a doctor.

5. Blood in stool and urine
Certain health conditions associated with the bladder can cause darker urine or stools, indicating blood presence. For instance, certain bladder infections can cause these issues and other symptoms like frequent urination, abdominal pain, and lower back or flank pain. When dealing with ITP, one may notice blood in stool and urine without other bladder- and bowel-related symptoms. This should prompt one to seek an ITP diagnosis from a doctor.

6. Excessive fatigue
Red blood cells (or RBCs) are responsible for transporting oxygen throughout the body, which helps tissues and organs function properly. But when dealing with ITP, there could be issues maintaining the ideal RBC count. This is because after bleeding, the body generally needs time to replace the blood. With ITP, there is often excessive bleeding, making the body take even longer to restore blood cell levels. This leads to anemia or a shortage of red blood cells, which is known to cause fatigue. So, those affected may need to sleep more than usual, require daytime naps, feel tired during the day even after a good night’s rest, and experience a lack of energy when carrying out daily activities.

7. Heavy periods
A menstrual cycle typically lasts four to seven days and occurs approximately every 28 days. Sometimes, women may experience an irregular period or excessive flow. Several factors may be responsible for this issue, including changes in hormone levels and stress. Additionally, a heavy menstrual cycle could be a result of ITP. It is important not to ignore this symptom and to seek treatment immediately, as regularly heavy periods can lead to other complications, like anemia.

8. Heavy nosebleeds
A nosebleed, also called epistaxis, is bleeding in the tissue that lines the inside of the nose. The bleeding might result from a combination of dry air entering and irritating the tiny blood vessels that line the inner surface of the nose. The bleeding can develop in one or both nostrils. Although typically, a nosebleed stops in a short while, with ITP, it can go on for long periods. If one notices frequent, heavy nosebleeds, especially without exposure to dry air, they should consult a doctor and seek appropriate treatment.

Causes
The precise cause of ITP is unknown, but the disease typically develops when the immune system antibodies misidentify platelets (a type of blood cell) as invaders and attack them . This reduces the platelet count in the body. Normally, when something damages or cuts the blood vessels, platelets reach the damaged area and stick together to form clots, which stop the bleeding. When dealing with ITP, the lack of platelets delays or prevents the clotting around the wound, leading to an excessive loss of blood.