Purpura
Original Editors - Students from Bellarmine University's Pathophysiology of Complex Patient Problems project.
Top Contributors - Kylie Smith, Lucinda hampton, Elaine Lonnemann, Kim Jackson and WikiSysop
Definition/Description[edit | edit source]
Purpura is a hemorrhagic condition that occurs when not enough normal platelets are available to plug damaged vessels or prevent leakage from even minor injury to normal capillaries. Purpura is characterized by movement of blood into the surrounding tissue (extravasation), under the skin, and through mucous membranes, producing spontaneous ecchymoses (bruises) and petechiae (small, red patches) on the skin [1]. Purpura measure between 4 and 10 mm (millimeters) in diameter. When purpura spots are less than 4 mm in diameter, they are called petechiae. Purpura spots larger than 1 cm (centimeter) are called ecchymoses [2]. There are many different types of purpura. Their classification depends on the appearance or cause of the condition.
Idiopathic thrombocytopenic purpura (ITP), also known as primary immune thrombocytopenic purpura and autoimmune thrombocytopenic purpura, is defined as isolated thrombocytopenia with normal bone marrow and in the absence of other causes of thrombocytopenia. ITP has two distinct clinical syndromes, with typical manifestation of an acute condition in children (spontaneous resolution within 2 months) and a chronic condition in adults (lasting longer than 6 months) [3].
Prevalence[edit | edit source]
Frequency
- The incidence of ITP in adults is approximately 66 cases per 1,000,000 per year
- An average estimate of the incidence in children is 50 cases per 1,000,000 per year [3].
Age
- Peak prevalence occurs in adults aged 20-50 years.
- Peak prevalence occurs in children aged 2-4 years.
- Approximately 40% of all patients are younger than 10 years [3].
Characteristics/Clinical Presentation[edit | edit source]
Physical signs and symptoms include:
- Easy or excessive bruising (purpura)
- Superficial bleeding into the skin that appears as a rash of pinpoint-sized reddish-purple spots (petechiae), usually on the lower legs
- Bleeding from the gums or nose
- Blood in urine or stools
- Unusually heavy menstrual flow [4]
- Non-blanchable lesions [5]
Idiopathic thrombocytopenic purpura can occur in anyone at almost any age, but these factors increase the risk: [4]
- Your sex. Women are two to three times more likely to develop ITP than men are.
- Recent viral infection. Many children with ITP develop the disorder after a viral illness, such as mumps, measles, influenza or a respiratory infection.
Associated Co-morbidities[edit | edit source]
ITP is associated with a considerable number of medical conditions including hematological diseases, dermatological conditions, oral conditions, viral infections (such as Hepatitis C, HIV, measles, and mumps), gastrointestinal, bleeding, and autoimmune disorders. One possible cause of associated signs and symptoms could be due to an adverse drug reaction. However, further research is needed to identify the cause and extent of the association between these conditions and ITP [6,7]
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