Tuesday, September 19, 2023

Can Itp Be Caused By Stress

Be Prepared For Injuries

Leukocytosis, Causes, Signs and Symptoms, Diagnosis and Treatment.

The key issue is to be prepared for when a bleeding episode happens, says Dr. Tellez, since its inevitable that youll injure yourself and bleed at some point. This means having bandages and gauze pads on hand and applying gentle pressure to cuts when covering them.

While some people with ITP are at high risk for bleeding and will need to follow stricter precautions for injuries, such as topical or oral medications, most people who have ITP can treat minor cuts in the usual manner, says Tellez.

What Are The Complications Of Thrombocytopenia

People with severe thrombocytopenia are at risk for significant internal and external blood loss, or hemorrhage. Internal bleeding into the digestive tract or brain can be life-threatening.

Having a splenectomy makes you more susceptible to infections. Your spleen is part of your immune system. It helps your body fight off germs. For this reason, patients who have to have their spleen remove are given several vaccinations to help prevent infection.

Table 1 Comprehensive List Of Themes

Inability to get out of bed Spouse
Fear of low platelet counts
Bruises that never go away Fear of dying
Stress contributes to low platelet levels
Other Anxiety about low platelet levels
Migraines Anxiety medical profession’s lack of knowledge
Visual impairment Depression, Isolation, oss of Control
Joint aches
Feels pressure to be strong
Choice of clothing limited due to bruising
Lump in back
More susceptible to colds and fungal infections
f. Social and Leisure Activities
Daily Activities
Unable to go to the gym
Fatigue limits daily activities Unable to do sports, boxing, martial arts, skydiving, climbing, dancing
Extreme care in doing simple tasks Leisure activities
Unable or too tired to go out with friends
Inability to plan for the future Travel is limited or more difficult
Reduction in risk-taking activities Feelings of isolation due to physical and emotional effects of ITP
Hide the severity of disease from family Social stigma
People suspect spousal or parental abuse due to bruising

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When Should I See A Doctor For Itp

If you show any symptomsbruises and/or a rash of red dots that appear out of nowhere, or nosebleeds that wont stopsee your doctor. Your primary provider can order a blood count or may send you to a hematologist, a specialist in blood disorders, to figure out whats going on. And dont be shy: Ask if your hematologist is savvy about ITP and other platelet disorders.

Know Your Body And What To Look Out For

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I think an important part of self-care is to know what to look for, says Terry B. Gernsheimer, MD, a hematologist and professor of medicine and hematology at University of Washington Medicine in Seattle. To know what a petechia looks like to be cognizant when you bump yourself, saying, If a big bruise appears, I know where it came from.

This also means regularly monitoring your body for bruises, especially ones without known causes, says Dr. Gernsheimer. Unusual bruising or a heavier-than-usual menstrual period may indicate that your platelet count is dropping, and it may be a good idea to check in with your doctor.

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How Is Itp Diagnosed

ITP is identified by a diagnosis of exclusion. There is no single blood test that can prove whether a patient has ITP, so it has to be a process of eliminating other possible causes based on a patients history, on examinations, and on the results of initial tests. In diagnosing ITP, the healthcare provider will carry out blood tests to identify the underlying causes of low platelets. ITP is diagnosed if blood tests show that only the platelet count is low while the platelets, red blood cells and white blood cells all look normal.

In cases of persistent ITP, a bone marrow biopsy may be recommended to rule out other causes for a reduced platelet count. A small sample of bone marrow is taken under local anaesthetic and examined under the microscope. If the bone marrow is free from abnormalities and other blood tests are normal, then chronic ITP will be diagnosed.

Low Platelet Count Causes

Wondering what causes the abnormalities described above? According to the National Heart, Lung and Blood Institute, some of the most common underlying reasons for alternations in normal blood platelet counts include:

  • Enlarged spleen: The spleen helps fight infections and clean the blood, so illnesses that cause an enlarged spleen can cause too many platelets to become trapped inside while the body tries to fight off bacteria or a virus. In healthy people, around one-third of the bodys platelets are held in the spleen, but conditions like liver disease/cirrhosis prevent scarring, which keep platelets harbored inside.
  • Reactions to medications and over-the-counter drugs: Platelet production can be altered due to the use of drugs, including diuretics, NSAID anti-inflammatory drugs and antibiotics, or frequently taking common painkillers like ibuprofen and aspirin.
  • Autoimmune diseases: Diseases like lupus and rheumatoid arthritis cause the immune system to mistakenly attack and destroys platelets. This is called immune thrombocytopenia or ITP.
  • Alcohol: Alcohol slows the production of platelets and is the biggest problem when its consumed excessively, especially if someones diet is also low in nutrients.
  • Toxin exposure from the environment: Chemicals commonly found in the environment, including pesticides, arsenic and benzene, can all slow the production of platelets.

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Treatment For Adults With Itp

Adults with ITP have a range of treatment options. Here’s are some of the possible approaches your hematologist may recommend.

Monitoring Without Meds

Youll see your doctor for blood counts, but only if your platelets are above 30,000, youre younger than 60, you dont have other conditions , and you only have mild bruising or petechia.

Otherwise your doctor will likely move on to one of the following first-line treatments if youre newly diagnosed .


Doctors typically give steroids, like dexamethasone, via an IV if your platelet count is very low and needs to be bumped up quickly. Sometimes a course of steroids does the trickthis is true for people whose ITP was triggered by an infection or a vaccinebut 75% of patients relapse, so steroids usually bridge the gap to second-line treatments.

Intravenous Immnoglobulin

Immunogloblin therapy is given alone or in combination with steroids. This is another first-line treatment to increase platelets. You can get a higher dose spread out over two days or a lower dose spread out over five.

Second-line treatments are given to persistent cases as well as chronic cases, those patients whove had ITP for longer than 12 months after their diagnosis.


Thrombopoietin-Receptor Agonists

  • Nplate , an injection

  • Promacta , a tablet

  • Doptelet , a tablet


Education And Patient Perceived Knowledge Deficits

TTP: Thrombotic Thrombocytopenic Purpura – Signs, Symptoms, and Treatment
  • Patients and caregivers want providers to have current knowledge about ITP and be aware of updated guidelines and how to use them, clinical trials and research, and all available second-line therapies .

Often, the discovery of a low platelet count is made by an emergency physician or a family doctor when a patient shows up with unexplained bruising or petechiae. Patients want ITP specialists to educate their colleagues to provide correct information and management recommendations while they wait for a hematologist to become involved.

ITP patients want to be informed of the risks and benefits so they can make an informed choice aligned with their treatment goals. Patients also want to be made aware of resources about their disease and how to connect with others living with their same rare disease . This need has also previously been documented among parents of children with complex and often rare disorders .

Table 1

Possible solution: Health care providers treating ITP patients should stay current on research in the field, including updated protocols and best practices. Since ITP is heterogenous and a rare disease, it is essential that health care providers consider using guidelines written by ITP experts when making clinical judgements. They could also consider when new guidelines are developed to hold rounds or present to their colleagues such as pediatricians, family doctors, emergency staff, and inpatient providers.

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Does Itp Come Back And Other Questions Answered

Immune thrombocytopenia is an autoimmune disease that causes low platelet levels.

Platelets are cell fragments in your blood that help it clot when you injure yourself. Having too few platelets can make you bruise or bleed more easily than usual.

Sometimes ITP can come back after treatment. Here are answers to common questions about when ITP comes back.

There are three types of ITP:

Depending on the type of ITP you have, it can come back.

Acute ITP, which is also called newly onset ITP, is the most common form of the condition. It comes on suddenly, with symptoms lasting for fewer than 3 months. This type usually:

  • occurs in younger kids
  • doesnt require treatment
  • doesnt come back

About 80 percent of kids who are newly diagnosed with ITP will have a case that resolves within 12 months, according to the National Organization for Rare Disorders. More than 50 percent of newly-diagnosed adults will go on to have chronic ITP, the group estimates.

Persistent ITP lasts for between 3 to 12 months. It usually doesnt go into remission on its own and doesnt always go away after treatment.

Chronic ITP lasts for at least 12 months. Its more common in adults and can come back frequently. Symptoms start more gradually and can last up to several years.

Chronic ITP isnt curable. With chronic ITP, youll have remission periods when your symptoms improve for months or even years.

But eventually chronic ITP symptoms recur. Some people with chronic ITP have many recurrences.

Bacteria And Virus Byproducts

This theory suggests that ITP may be caused by a persons immune response being confused between its own cells and invading virus and bacteria.

When a virus or bacteria invades our body, special cells chop it up into thousands of fragments and put some of these fragments in a type of pocket for the immune system to disable. T-cells latch on to the fragments in the pocket and send signals to destroy all of the tissues that have the same or similar makeup. The problem comes when the fragment to be destroyed looks like part of a platelet. In that case, antibodies attach to platelets as well as the fragments on other cells resulting in both the invaders and the platelets being destroyed.

In a similar theory, when our body is fighting a reaction, it produces a compound called interleukin-12 during its normal immune response. Interleukin-12 then creates many other immune compounds specific to a particular microbe. Researchers think this flurry of activity may activate any dormant self-reactive cells near the infection.

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What Is The Prognosis For People With Thrombocytopenia

A low platelet count increases your risk of hemorrhage or severe bleeding. Excessive bleeding whether internal or external can be life-threatening. Many people with thrombocytopenia have mild to moderate symptoms. Platelet levels often go up when you treat the underlying cause or change medications.

People With Immunodeficiency Disorders


Sometimes your immune system goes haywire, thanks to an inherited condition known as an immunodeficiency disorder. These are rare, genetic diseases that damage your immune system, making you more susceptible to autoimmune conditions and, in some cases, chronic infections and even cancer. If you have common variable immunodeficiency , for instance, your immune system has trouble making antibodies, putting you at higher risk for ITP . While most of these disorders are diagnosed at birth or soon after, CVID is usually caught during adulthood. CVID and other immunodeficiency disorders might account for roughly 2% of all secondary ITP cases.

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How Does The Immune System Target Platelets In Itp

Two ways: First, in the early stages of ITP, a type of white blood cell called B lymphocytes, a.k.a. B cells, get involved. Like other white blood cells, theyre used by your immune system to fight off infections. B-cells produce antibodies when your body is exposed to something harmful, like bacteria or viruses. In this case, the antibodies attach themselves to your healthy platelets and get destroyed by other white blood cells , which remove waste and harmful substances from the body.

As the disease progresses, other disease-fighting lymphocites, called T-cells, show up to the party. T-cells do different jobs: Some regulate how your immune system responds to invaders, while others destroy those harmful substances. With this autoimmune condition, T-cells start destroying even more platelets and simultaneously suppress their production in the bone marrow . The longer you have ITP, the more your misfiring immune system kicks in: One set of cells is destroying platelets while the other is lowering their productionan unfortunate double whammy.

The result: Your platelet count goes down and keeps going down. A normal platelet count is between 150,000 and 400,000 per microliter of blood. Someone with ITP can have a platelet count of 30,000 or lower. And because your blood doesnt have the same ability to clot, you are at greater risk for internal bleeding, whether it happens in your GI tract, under your skin , or in the brain.

Wear A Medical Alert Bracelet

If you have ITP and your platelet count is below 50,000 , its a good idea to wear a medical bracelet to alert first responders and physicians about your condition should you end up having an accident and wind up in the ER. That way, theyll know to avoid blood thinners, say, or other medications that can potentially cause trouble.

Some people with ITP report having a lower quality of life because theyre worried about potentially fatal bleeds, theyre forced to curtail activities they love, or theyre embarrassed about wearing short sleeves and exposing a rash or so many bruises. If this is you, take heart: There IS support out there for this rare disorder. Youre not alone.

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Viral Infections And Itp

Often, a child may have had a virus or viral infection about three weeks before developing ITP. Scientists believe that the body, when making antibodies against the virus, may have “accidentally” made an antibody that sticks to the platelet cells. The body then recognizes these platelet cells with antibodies as foreign cells and destroys them. That is why ITP is referred to as an immune disease, because the body is attacking itself.

What Is High Platelets

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High platelets is a condition in which the blood contains more platelets than normal. Platelets are small blood cell fragments that assist in blood clotting. In a healthy person, there are usually 150,000 to 450,000 platelets per microliter of blood. A high platelet count can be identified through routine blood tests.

The occurrence of high platelets is divided into two medical categories: primary thrombocythemia and secondary thrombocytosis. In primary thrombocythemia, the cause of the high platelets is not known, and it occurs as an independent condition. In secondary thrombocytosis, high platelets occurs as a symptom of another disease or condition, such as anemia, infection or .

In many cases, high platelets may not produce specific symptoms. In other cases, the elevation in platelet levels leads to the development of unwanted and unnecessary blood clotting throughout the body, which can produce a number of symptoms.

The presence of high platelets is rarely associated with a medical emergency. However, in some cases, high platelets may cause blood clotting, bleeding or . Seek immediate medical care if high platelets are accompanied by a persistent , difficulty breathing, dizziness, , changes in speech, or or loss of consciousness for even a brief moment.

If your high platelets condition is persistent or causes you concern, seek prompt medical care.

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What Is Immune Thrombocytopenic Purpura

Immune thrombocytopenic purpura is a blood disorder characterized by a decrease in the number of platelets in the blood. Platelets are cells in the blood that help stop bleeding. A decrease in platelets can cause easy bruising, bleeding gums, and internal bleeding. This disease is caused by an immune reaction against one’s own platelets. It has also been called autoimmune thrombocytopenic purpura.

  • Thrombocytopenia means a decreased number of platelets in the blood.
  • Purpura refers to the purple discoloring of the skin, as with a bruise.

ITP is a fairly common blood disorder that both children and adults can develop.

There are two forms of ITP:

  • Acute thrombocytopenic purpura. This usually affects young children, ages 2 to 6 years old. The symptoms may follow a viral illness, such as chickenpox. Acute ITP usually starts suddenly and the symptoms usually disappear in less than 6 months, often within a few weeks. Treatment is often not needed. The disorder usually does not recur. Acute ITP is the most common form of the disorder.
  • Chronic thrombocytopenic purpura. The onset of the disorder can happen at any age, and the symptoms can last a minimum of 6 months, several years, or a lifetime. Adults have this form more often than children do, but it does affect adolescents. Females have it more often than males. Chronic ITP can recur often and requires continual follow-up care with a blood specialist .

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