James Bussel, MD, explains immune thrombocytopenia (ITP) in clear terms, from how low platelet counts are detected to why ITP remains a diagnosis of exclusion. He reflects on the importance of lab work, physical exams, and recognizing signs like petechiae to reach an accurate diagnosis.
Transcript
ITP in layman’s terms first requires someone to get a platelet count. That could either be a yearly physical, preoperative screening, or because there are signs of bruising or bleeding, especially what are called petechiae, little red dots. And then a physician obtains a platelet count.
And the definition of ITP would then be the platelet count less than 100,000 without other signs of disease, focused mainly on the other parts of the blood count — red cells and white cells being normal.
And nothing obvious on physical exam, such as an enlarged liver and/or an enlarged spleen.
So if you have a low platelet count — meaning less than 100,000 — and the rest of your blood count is normal, and there’s nothing remarkable on your blood film when looked at under the microscope, and the physical exam does not suggest that there is another ongoing disease, then you have ITP.
It is still currently a diagnosis of exclusion, meaning you try to find these other possible entities, and if they’re not there, then you say it’s ITP.