Immune Thrombocytopenia: 7 Facts To Know

Medically reviewed by Warren Brenner, M.D.

Written by Sherri Gordon, CLC

Posted on August 6, 2026

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Key Takeaways

Immune thrombocytopenia (ITP) is a rare blood disorder in which the immune system mistakenly attacks and destroys platelets, leading to a low platelet count and an increased risk of bruising and bleeding.

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If you or your child has been diagnosed with immune thrombocytopenia (ITP), it’s important to learn as much as you can about this rare blood disorder. Understanding ITP can help you ask informed questions, work with your healthcare team, and take steps to stay safe.

Here are seven facts about ITP everyone with the condition should know, including how it affects your body, how it’s managed and treated, and what you can do to stay healthy and minimize bleeding risks.

1. Immune Thrombocytopenia Is an Autoimmune Disorder That Affects Platelets

If you have ITP, your immune system makes antibodies that attack and destroy your platelets because it mistakes them for harmful invaders. This means your immune system actively works to clear platelets from your body, which results in a low platelet count.

If you have ITP, your immune system makes antibodies that attack and destroy your platelets because it mistakes them for harmful invaders.

When your platelet count is low, you may bruise more easily or bleed longer after a cut or an injury. Some people with ITP may also have bleeding without an obvious injury. The severity of your symptoms often depends, in part, on how many platelets you have.

In general, a platelet count below 10,000 per microliter of blood carries the highest risk of serious bleeding. A platelet count between 10,000 and 50,000 per microliter is considered moderate, while a count above 50,000 platelets per microliter is considered mild.

2. Immune Thrombocytopenia Can Be Primary or Secondary

There are two types of ITP — primary and secondary. When you’re diagnosed with ITP, your healthcare provider will determine which type you have.

Primary ITP has no known underlying cause or associated condition. About 80 percent of people with immune thrombocytopenia have primary ITP. Secondary ITP develops because of another condition or trigger.

Possible causes of secondary ITP include certain medications, infections, blood cancers such as leukemia, and autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus.

ITP is grouped into three phases based on how long you have had the condition:

Newly diagnosed ITP — The first three months after diagnosis
Persistent ITP — Three to 12 months after diagnosis
Chronic ITP — More than 12 months after diagnosis

3. Immune Thrombocytopenia Affects Children and Adults Differently

If you’ve been diagnosed with ITP, your age at diagnosis can affect how the disease will likely progress. For example, children are more likely than adults to experience spontaneous remission, whereas adults are more likely to develop chronic (long-lasting) ITP.

In many children, ITP develops after a viral infection or another illness. Adults are more likely to develop chronic ITP, which may require long-term treatment. Even so, there’s no way to predict how the disease will progress in any one person.

In many children, ITP develops after a viral infection or another illness. Adults are more likely to develop chronic ITP and may need long-term treatment.

About 80 percent to 90 percent of children with ITP recover within a few weeks or several months. In contrast, ITP in teens often behaves more like ITP in adults. Symptoms may last for months, and some teens develop chronic ITP.

4. Symptoms Range From Invisible to Serious

If you have ITP, you may be asymptomatic, meaning you don’t have any symptoms. If ITP symptoms do occur, they can range from mild to severe and often depend on how low the platelet count is. Symptoms may include:

Petechiae (tiny red or purple spots on the skin), often on the legs
Purpura (red, purple, or brown patches)
Easy bruising
Bleeding gums
Blood in the stool or urine
Nosebleeds that are hard to stop
Heavy or prolonged menstrual cycles
Fatigue (extreme tiredness that doesn’t improve with rest)

5. ITP Is Diagnosed by Ruling Out Other Causes

If you have symptoms of ITP, your healthcare provider will first look for other conditions that can cause low platelet counts, such as blood cancers, autoimmune disorders, infections, or certain medications. They may also test for human immunodeficiency virus (HIV), hepatitis C, or the stomach bacteria Helicobacter pylori.

Because no specific test can diagnose ITP, healthcare providers consider it a diagnosis of exclusion. This means they rule out other possible causes of low platelet counts before diagnosing ITP. During this evaluation, your doctor may recommend:

A complete blood count — A blood test that measures platelet count and other blood cells
A peripheral blood smear — A blood sample that’s examined under a microscope to evaluate platelets and other blood cells
A bone marrow test — A test that checks the health of bone marrow if a healthcare provider suspects another blood or bone marrow disorder

Bone marrow tests aren’t routinely needed to diagnose ITP but may be recommended in certain situations, such as when test results are unusual, treatment isn’t working as expected, or another condition is suspected.

6. Several Treatment Options Can Help Manage ITP

If your platelet count warrants treatment, your hematologist will likely begin with first-line therapies or treatments. If these don’t work well enough or you develop concerning side effects, they may move on to second-line approaches.

Treatment Type	Medication or Procedure	Considerations
First-line treatment	Corticosteroids	A short course of prednisone or dexamethasone is commonly used to quickly raise platelet counts.
First-line treatment	Intravenous immunoglobulin (IVIG)	IVIG can raise platelet counts quickly, but the effect is usually temporary.
Second-line treatment	Thrombopoietin receptor agonist (TPO-RAs) such as eltrombopag (Promacta)	TPO-RAs help the bone marrow make more platelets.
Second-line treatment	Rituximab	This medication may help reduce immune attacks on platelets in some people.
Second-line treatment	Rilzabrutinib (Wayrilz)	This Bruton’s tyrosine kinase inhibitor is approved for adults with chronic ITP who have had an inadequate response to previous treatment.
Second-line treatment	Fostamatinib disodium hexahydrate (Tavalisse)	This spleen tyrosine kinase inhibitor is used when other treatments have not worked well enough.
Second-line treatment (surgery)	Splenectomy (removal of the spleen)	This procedure may provide long-lasting remission for some people but increases the lifelong risk of certain infections.

Researchers continue to study new treatments for chronic ITP. Clinical trials are evaluating several anti-CD38 antibodies, including daratumumab, mezagitamab, and CM313. Although early results are promising, these treatments are still considered investigational and are not part of standard ITP care.

7. Living With ITP Requires Ongoing Monitoring and Precautions

If you have ITP, it’s important to see your hematologist regularly. They can monitor your platelet count, check how well your treatment is working, and adjust your medications if needed.

At home, you can also take steps to lower your risk of bleeding and other complications. Here are some strategies for staying safe.

Be Cautious With Over-the-Counter and Prescription Medications

Some medications can increase the risk of bleeding or affect how well your blood clots. Always talk with your doctor before starting or stopping any medication, but general recommendations include:

Avoid aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, unless your doctor recommends them.
Don’t take blood thinners unless they’ve been prescribed by your doctor.
Ask your hematologist before taking any over-the-counter medications, herbal products, or dietary supplements.

Protect Your Health

Most people with ITP can lead active, healthy lives. However, taking a few precautions can help lower your risk of bleeding:

Choose low-contact sports and physical activities. Avoid sports with a high risk of head injury, such as boxing, football, and martial arts.
Use an electric razor instead of a blade, and be careful when using nail clippers and scissors.
Consider running a humidifier to moisten dry air that contributes to nosebleeds.
Avoid picking your nose, and blow your nose gently.
Brush your teeth with a soft-bristled toothbrush. If your gums bleed often, ask your dentist or healthcare provider whether a sponge toothbrush is appropriate.
Wear sturdy shoes to help protect your feet from cuts and injuries.
Consider wearing protective gloves and long pants when gardening.
Limit alcohol because it can affect platelet production and function, increasing the risk of bleeding.
Watch for signs of infection, especially if you’ve had your spleen removed. Contact your healthcare provider if you develop symptoms such as fever.