INTRODUCTION
Idiopathic thrombocytopenic purpura (ITP) is a bleeding disorder in which the immune system destroys platelets, which are necessary for the blood clotting. It is an autoimmune disease with antibodies detectable against several platelets surface antigens
It is also known as immune thrombocytopenic purpura. Normally, the blood clots due to the presence of the platelets in the blood; if platelet count decreases, then blood clot formation takes place slowly and as a result there is an excessive bleeding. It affects both children and adults. In children it usually recovers by itself without treatment but in adults, the disorder is chronic. Idiopathic thrombocytopenic purpura is more common in women than men and more common in children than adults. In children the disorder often, occurs after viral infection such as mumps and the flu. In adults, it is more often chronic disease and occurs after the viral infection and with the use of certain drugs like in pregnancy.
WHAT ARE THE CAUSES OF IDIOPATHIC THROMBOCYTOPENIC PURPURA?
The exact cause of idiopathic thrombocytopenic purpura is not known. In this disease, the immune system does not work properly and start attacking the platelets, as if they are foreign substance for the body. Antibodies produced by the system get attached to the Platelets. The spleen, which helps to fight against the infection recognizes the antibodies and removes the platelets from the system. In ITP the platelet count is below 20,000, while normally it is 150,000 platelets per micro liter of circulating blood.
WHAT ARE THE DIFFERENT TYPES OF THE IDIOPATHIC THROMBOCYTOPENIC PURPURA?
The different types of the Idiopathic thrombocytopenic purpura are as follows:
Acute ITP: It is the most common type of disorders. It usually lasts less than six months and mainly occurs in the children.
Chronic ITP: It usually lasts for six months or more than that. It is mainly seen in teenagers and adults.
WHAT ARE THE SIGNS AND SYMPTOMS OF THE IDIOPATHIC THROMBOCYTOPENIC PURPURA?
Formation of the purpura (bruises).
Superficial bleeding in the skin that appears as of pin-point sized reddish purple spots usually on the lower legs.
Bleeding from the nostrils and gums.
Blood in urine and stools.
Menorrhagia (Excessive bleeding).
Prolonged bleeding from the cuts.
Excessive bleeding during surgery.
WHAT CAN BE THE RISK FACTORS OF THE IDIOPATHIC THROMBOCYTOPENIC PURPURA?
Idiopathic thrombocytopenic purpura can occur at any age, there can be few risk factors:
Sex: Women are more prone to this disease than men.
Recent Viral Infection: Viral infections like mumps and the flu are the risk factor for this disease.
WHAT CAN BE THE COMPLICATIONS OF THE IDIOPATHIC THROMBOCYTOPENIC PURPURA?
The most common complication of the ITP is intracranial hemorrhage.
Normally for the treatment corticosteroids are used, prolonged use of corticosteroids will produce some of the side effects, which are as follows:
Cataract.
Osteoporosis.
An increased risk of infection.
High blood sugar.
A loss of muscle mass.
WHAT ARE THE METHODS TO DIAGNOSE THE IDIOPATHIC THROMBOCYTOPENIC PURPURA?
Following are the methods to diagnose the idiopathic thrombocytopenic purpura:
Medical history.
Physical examination.
Complete blood count.
Bone marrow examination.
AYURVEDIC TREATMENT FOR ITP (IDIOPATHIC THROMBOCYTOPENIC PURPURA)
Planet Ayurveda is a herbal manufacturing company. It provides herbal formulation for the various health diseases. As we know in idiopathic thrombocytopenic purpura platelets count decrease. Plantbased ayurveda provides an effective Ayurvedic treatment for ITP (Idiopathic thrombocytopenic purpura). These are herbs especially to increase the platelet count.
HERBAL REMEDIES FOR ITP
ITP Combo Pack For Adults
Immune Booster - 2 capsules twice daily
Ashwagandha Capsules - 2 capsules twice daily
Giloy Capsules - 1 capsules twice daily
Gandhak Rasayan - 2 tablets twice daily
Green Essentials - 2 capsules twice daily
Kumar Kalyan Ras - 1 tablets twice daily
Brahmi Chyawanprash - 1 teaspoonful twice daily
Suvarna Basant Malti Ras - 1 tablet twice daily
These should be consumed for 1 or 2 months and the results will be visible. The allopathic medicines of the patients can be reduced slowly. The above mentioned combination contains Ayurvedic herbo mineral and metallic preparations as well. All preparations are safe for human consumption and are approved by government of India for their use in various health conditions.
ITP Combo For Children (3 Years To 14 Years)
Giloy Capsules - 1 capsule twice daily
Ashwagandha Capsules - 1 capsule twice daily
Gandhak Rasayan - 1 tablet twice daily
Immune Booster - 2 capsules twice daily
Green Essentials - 1 capsule twice daily
Brahmi Chyawanprash - 1 tablespoonful twice daily
Pitta Balance - 1 capsule twice daily
Kumar Kalyan Ras - 1 tablet twice daily
Suvarna Basant Malti Ras - 1 tablet twice daily
ITP Combo For Infants (Less Than 3 Years)
Since ITP affects many children but there are herbs and herbo mineral preparations which can help the infants and small children very much. Slowly reduce their dosage of steroids as soon as the effect of herbs / herbomineral compound is visible.
Giloy Capsules - 1 capsule twice daily
Ashwagandha Capsules - 1 capsule twice daily
Gandhak Rasayan - 1 tablet once daily
Immune Booster - 1 capsule twice daily
Kumar Kalyan Ras - 1 tablet once daily
Infee Syrup - 2 teaspoonful twice daily
Arvindasava Syrup - 2 teaspoonful twice daily
Praval Panchamrit - 1 tablet twice daily
Open up the capsules and pour the ingredients in a bowl and mix them with the Syrups. Crush the tablets and mix the powder in the syrup and then feed the child this mixture twice daily.
WHAT ARE THE PRECAUTIONS FOR THE IDIOPATHIC THROMBOCYTOPENIC DISORDER?
The cause of ITP is not known, hence there is no specific way to prevent this. However, bleeding and injury can be serious for the ITP sufferer, to decrease the chances of the bleeding injuries:
Children should wear helmets while playing.
Avoid playing contact sports like football.
Avoid medications like aspirin and ibuprofen as these medications decrease platelet activity.
More About ITP
Immune thrombocytopenia causes low platelets in blood. Normal count is more than 2,50,000 ( 20 years ago, but now 1,50,000 is considered normal) but in ITP it can come down to dangerously low levels of less than 20,000 . The patient needs hospitalization if the platelets are less than 20,000 but if they are more than 50,000 then it's is still considered a safer zone.
Less than 10,000 platelets can lead to bleeding, which can be dangerous. In ITP the patient produces abnormal antibodies (our own army) which sticks to platelets and when they go through spleen, the spleen destroys them.
The bone marrow is producing the platelets normally but the body is destroying them too quickly. Normal age span of platelets is 7 to 10 days but in case of ITP they survive only for few hours and thus the count remains very low.
SYMPTOMS OF ITP IN CHILDREN
Acute ITP or Acute thrombocytopenia is common affecting more than 90 % of children between age of 2 to 6. Acute ITP gets resolved on its own with proper diet and care. If there are serious symptoms, then above mentioned allopathic medicines are given by doctors. Chronic ITP is more common in adults than in Children. Chronic ITP needs more care than acute ITP. Bruises, Blue spots, reddish or dark red or bluish spots over body are symptoms. Fatigue, tiredness, irritability are also sometimes the symptoms of ITP.
HOW TO DIAGNOSE ITP IN CHILDREN?
Careful medical history is important to make a diagnosis
Complete physical examination
CBC or complete blood count to check platelet count
Bone marrow biopsy to check if the platelets are being formed in bone marrow or not?
After all these tests, and confirmed diagnosis, the doctors start the treatment of ITP.
WHAT IS THE TREATMENT OF ITP IN CHILDREN?
There is actually no cure of ITP – idiopathic thrombocytopenic purpura but the treatment consisting of steroids, dapsone and immunosuppressant is given. Majority of children get better gradually on their own which can be with or without treatment. Ayurvedic treatment however helps them a lot as it is done on Ayurvedic principles.
Intravenous Gamma Globulin – Also called IVIG is an injection given to ITP patients but it's expensive and in many cases it does not work. It is made from human blood containing antibodies that help to slow down the rate at which abnormal platelets are destroyed by the spleen. Fever, Chills, headache, muscle and joint pain, rashes or allergic reaction can be the side effects.
IntraVenous RHO ( D) immune Globulin – Also called WinRho- It's another human plasma medicine which works temporarily to stop the spleen from destroying platelets. Only RH positive blood type children can receive this injection and they should also have their spleen in their body. The same side effects like IvIg.
OTHER TREATMENTS
Splenectomy – Usually done in older children and adults with Chronic ITP. Ayurveda recommends use of natural medicines before taking such decisions.
6 Mercaptopurine ( Purinethol or 6 MP) – It’s also immunosuppressant.
Hormone therapy to counteract the side effects of drugs or to control the excessive menstrual bleeding in girls due to low platelets.
OUTLOOK OF ITP CHILDREN IN GENERAL – PROGNOSIS
Most of the children recover on their own in ITP but others pass into chronic stage. Fatal brain hemorrhage or other eye hemorrhage can be problematic. There is no cure for ITP in modern medical system. A lot of research is however going on. Ayurveda is an age old healthcare system with no mention of ITP in ancient texts but similar disease with similar symptoms. The herbs and mineral which are used to treat that condition have helped many of my patients. Once recovered from ITP, the recurrence is not common. Another viral infection can however trigger the event again in very rare cases.
Most frequent question asked by many is:-
Can my child play sports or do running or jogging? Can my child participate in athletic activities? Can my child travel in an airplane or travel at all?
The answer is it all depends up the platelet count. If its more than 50,000 then the child is in safe zone. He can do all these activities but under monitoring and care.
Less than this no, it's not allowed. Travelling in airplane or ship is also allowed if the count is more than 50,000
Less than 20,000 count is dangerous and needs platelet transfusion or hospital admission.
It's also very important to take care of hydration of the child. Water or fresh fruit juices, vegetable smoothies should be given every day.
Milk and milk products should be avoided.
Take special care in winter season to avoid cold and flu
Anti-biotics use should be minimized.
Ibuprofen is contraindicated in low platelets
Herbs like black pepper or chillis or Turmeric, Ginger which cause blood thinning should not be consumed.
There are hot in potency and can prevent platelet aggregation and lead to bleeding.
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