Chronic Immune Thrombocytopenia (ITP): Symptoms, Causes, Treatment

Written by Evan Starkman
Medically Reviewed by Neha Pathak, MD on January 05, 2026

Immune thrombocytopenia (ITP) is a rare blood disorder. Your immune system mistakenly destroys platelets, which help your blood clot after an injury. The lack of platelets can make you bruise or bleed more easily. Idiopathic thrombocytopenic purpura is an older name for this condition.

Sometimes, ITP goes away on its own without treatment. In other cases, the condition is chronic and needs long-term treatment to manage.

Who gets ITP?

 

ITP is very rare, and it can happen at any age. About 9.5 out of every 100,000 people in the U.S. have ITP.

Children more often have the acute form, while chronic ITP affects more adults. A recent study reports about 8.8 in 100,000 children have ITP in the U.S.

Doctors group ITP into different types based on their causes:

You also may hear your doctor talk about your ITP in terms of how long you've had symptoms:

Acute ITP. This type usually lasts for less than three months. Doctors sometimes call it newly diagnosed ITP. It's the most common type. Acute ITP mostly affects children ages 2 to 5 after they've had a viral infection. About 1 in 4 children with acute ITP go on to develop chronic ITP.

Persistent ITP. This type lasts for at least three months and up to a year.

Chronic ITP. The chronic form lasts for more than 12 months. It mainly affects adults, but sometimes children and teens get this type, too.

ITP vs. TTP

Thrombotic thrombocytopenic purpura (TTP) is another rare blood disorder. People with TTP don't have enough of an enzyme called ADAMTS13 that helps your blood clot. Without this enzyme, blood cells stick together too much. 

The sticky blood cells can form lots of clots in small blood vessels. The blood clots can also block the flow of blood to your vital organs like the brain, heart, or kidneys. Too much clotting can also use up platelets you need to stop the bleeding when you're hurt.

TTP is very serious. A lack of blood flow can damage organs or cause a stroke.

A problem with your immune system causes ITP. Your immune system makes proteins called antibodies that normally target viruses and bacteria. In this case, antibodies mistakenly tag platelets as foreign invaders. Then the immune system sends out white blood cells to attack your tagged platelets. This can destroy them, lowering your number of platelets.

 

Chronic ITP is up to three times more common in women than men. You may be at higher risk if you:

  • Have an infection like HIV, hepatitis C, cytomegalovirus, or varicella zoster (the virus that causes herpes and shingles)
  • Have an autoimmune disease like rheumatoid arthritis or lupus
  • Take certain blood thinners, antibiotics, or seizure medicines
  • Have a cancer like chronic lymphocytic leukemia (CLL), lymphoma, or adenocarcinoma
  • Have an underactive thyroid gland or Addison's disease

Most children develop ITP after having a viral infection the month before. Rarely, they can develop ITP after getting a live vaccine such as measles-mumps-rubella (MMR). But these cases typically go away after about six months.

If you have a big drop in platelets, you’ll bruise or bleed more easily. 

What's the first sign of ITP?

Many people have no symptoms in the early stages when ITP is mild. Once your platelet count drops very low, you may bruise or bleed more easily than usual.

Other ITP symptoms

How long do symptoms last?

Acute ITP symptoms often disappear after a few weeks. Chronic ITP symptoms last for a year or longer. The symptoms can continue for many years, or even for a lifetime.

To diagnose ITP, the doctor will ask about your medical history and family history. They'll look at your skin for the bruises and bleeding that ITP causes. You may need more tests to rule out other possible causes of your bruising and bleeding.

Testing for ITP

Tests like these can rule out other conditions with similar symptoms:

Blood tests. A complete blood count (CBC) measures the number of platelets and other cells in a sample of your blood. You'll also get a comprehensive metabolic panel (CMP) to check your body's metabolism. This test can help your doctor see how your liver is working, too.

Another blood test checks for the antibodies that attack platelets in ITP. Your doctor might also test you for infections like HIV or hepatitis C that can cause ITP.

Peripheral blood smear. This test examines your platelets under a microscope to look for changes.

Hematologists are the specialists who treat blood disorders like ITP. You may see a hematologist for regular follow-up visits to monitor your disease. Your treatment team might also include nurses, plus a surgeon if you need to have spleen removal surgery.

After an ITP diagnosis, your treatment team will meet with you and explain next steps. The hematologist will go over all the treatment options and whether you need to start on medicine right away.

If you don't need treatment, your doctor will schedule regular checkups to test your platelet count and make sure it doesn't get too low. The doctor will also tell you about lifestyle changes to help you live better with ITP.

ITP is a rare disease. You might not know anything about it when you get the diagnosis. Learning as much as you can about ITP will make you a more informed partner in your care.

Here are some questions to ask your doctor:

  • What do you think caused my ITP?
  • What's my platelet count, and is it too low?
  • Do I need to start on a treatment right away? Why or why not?
  • Which treatment do you suggest for me? How might it help me?
  • Will the treatment you're suggesting likely raise my platelet count for the short term or long term?
  • Does the treatment raise the risk of other health conditions?
  • How long will I need to stay on the treatment?
  • How will you track my health and treatment progress?
  • What are the next steps if a treatment I try doesn't work?
  • What side effects could the medicine cause? How can I relieve those side effects?
  • What lifestyle changes can help me manage ITP?

You'll want to choose a doctor who's skilled at treating people with ITP. Here are some further questions you can ask to get a sense of a doctor's experience and outlook on treatment:

  • How many years have you been caring for people with ITP?
  • How many people with the condition have you treated, and how is their health?
  • Do you have connections with any research group or hospital that specializes in noncancerous hematology?
  • What's your outlook on treating blood disorders like ITP? Do you prefer to treat diseases aggressively, or do you take a more conservative approach?
  • If I give you input on my care, would you welcome that? Or what about if I take an interest in learning about the disease and its treatment?
  • How do you feel about complementary treatments?

With a rare disease like immune thrombocytopenia, it's important to find a doctor or medical center that has experience treating the condition. Here are some tips to help you get started:

Search for an expert through the American Society of Hematology. This expert group's website has a "Find a Hematologist" feature that lets you search for a blood disorder specialist. You can find out if there's a hematologist near you and search for ones that have taken an interest in conditions that can involve a low platelet count, like ITP.

Contact the Platelet Disorder Support Association. You can fill out a form on this nonprofit group's site to request a list of ITP specialists.

Reach out to a rare disease nonprofit. Groups like Global Genes and NORD (National Organization for Rare Disorders) may be able to offer help with finding a doctor.

Look for a teaching hospital near where you live. Search for the largest one. Then call to ask for a referral to the chief of the hematology department or a specialist in noncancerous hematology.

Try a general search online. Enter a term like "top centers for immune thrombocytopenia." Carefully look over results, focusing on reputable hospitals or universities that have doctors or a hematology department with expertise in treating people with rare blood disorders. 

ITP may not need treatment. Your doctor might just check your platelet count and watch your symptoms on a regular schedule. Your treatment will depend on your platelet count and the risk and seriousness of a potential bleed.

Managing ITP symptoms

Corticosteroids are the first treatment for most people with newly diagnosed ITP and a low platelet count. These medicines may stop your immune system from destroying platelets. They can also lower your chances of bleeding for no reason (spontaneous bleeding). 

Once your platelet count improves, your doctor will lower the steroid dose a little at a time. Long-term corticosteroid use can increase your risk of infections, high blood sugar, weak bones, and other side effects.

You may need a platelet transfusion if you have:

  • Serious bleeding (is constant or causes you to fall)
  • Critical bleeding (bleeding in organs like your brain, stomach, or spine)
  • Platelets lower than 20,000 per microliter

You'll go to a hospital, where they'll transfer (transfuse) healthy platelets from a donor into your bloodstream right away. If you're bleeding and corticosteroids don't increase your platelet count enough, you may get intravenous immunoglobulin (IVIG). 

This medicine goes through a small tube into your vein. IVIG contains antibodies called immunoglobulins that stop your immune system from attacking your platelets. Because the effects wear off, you'll have to get IVIG once every two to four weeks.

When other treatments don't work

Corticosteroids and IVIG don't help everyone, but you’ll have other treatment options to consider. Sometimes, these treatments help for a while and then stop working. If it isn't working after three months, your doctor may try a less common medicine to increase your body's platelet production: 

  • Avatrombopag (Doptelet)
  • Eltrombopag (Promacta) 
  • Romiplostim (Nplate) 

Rituximab (Rituxan, Ruxience, Truxima) also increases platelets, but in a different way — it stops your immune system from damaging them. Fostamatinib (Tavalisse) is a newer ITP medicine that may be an option, too. But children shouldn't take fostamatinib because it may affect their growth. Another newer ITP medicine called rilzabrutinib (Wayrilz) may help some adults with persistent or chronic ITP that hasn't gotten better with standard treatments. The FDA approved it for adults with persistent or chronic ITP in 2025. But it can raise the risk of serious infections.

If medicine doesn't improve your platelet count, you might need surgery to remove your spleen, called a splenectomy. The spleen is part of your immune system. In ITP, it plays a big role in destroying platelets. Removing the spleen leads to long-term remission in about 60% of people who have this surgery. But without a spleen, you could have a higher risk of serious infections.

ITP can cause severe bleeding without treatment. The most serious complication is bleeding in the brain, which could be life-threatening.

ITP in pregnancy

You can get pregnant and have a healthy baby with ITP, but your hematologist and obstetrician will monitor you more closely during pregnancy. Some of the medicines that stimulate platelet production aren't safe for your baby, so you may need to switch to a different drug until after you deliver.

Because your platelet count can drop in the third trimester and cause serious bleeding, many doctors recommend bringing your platelet count up to 50,000 or higher close to your due date. Most babies whose mothers have ITP aren't born with low platelet counts. But their platelet counts should get checked soon after they're born to be sure.

ITP can be with you for many years. You may need to take medicine long-term to keep up your platelet count. During treatment, you can do a few things to stay healthy and prevent bruising and bleeding.

Tips for living With ITP

Be extra careful when doing any activities that could make you bruise or bleed. Avoid contact sports like football, ice hockey, or rugby. Wear a helmet when you ride a bike, skateboard, or motorcycle. And always put on your seatbelt in the car.

Use a soft toothbrush to keep your gums from bleeding. Shave with an electric razor. Be extra careful when using a knife, nail clippers, or other sharp tools. Wear shoes with thick soles when you go outside to prevent cuts on your feet.

Check with your doctor before you take any new medicine or supplement.

Life with a rare chronic condition can be very stressful. Mind-body techniques like meditation, yoga, or guided imagery can help you relax.

Acute ITP usually gets better within a few weeks or months. Chronic ITP can last for many years. Symptoms may come and go, but the condition is usually not life-threatening. You'll need medications or other treatments long-term to keep your platelet count up and prevent serious bleeding.

As treatments for ITP have improved, so have outcomes. But survival rates haven't improved equally in everyone with this condition. While deaths from ITP are down in White people, the outcome hasn't improved in people of color. One reason could be a lack of access to care. Also, darker skin might hide bruising and bleeding, leading to fewer people of color seeing a doctor for a diagnosis.

People of lower incomes also have worse survival rates. And those who live in rural areas are less likely to receive treatment from a hematologist than people who live in cities and suburbs. These disparities likely have to do with a lack of access to specialized care.

Children with ITP often have mild symptoms and get better without treatment. But adults with ITP most often need treatment eventually. In adults, the condition often becomes worse or long-lasting, also known as chronic.

You may need medications or other treatments to take charge of persistent or chronic ITP symptoms. There's no cure for chronic ITP, but many people who have it live well for decades.

When you need extra help, turn to family, friends, and your treatment team.

You can also go online and explore The Platelet Disorder Support Association's discussion groups. These groups let you chat with other people who have ITP or different platelet disorders. Chat topics include ITP treatment and being newly diagnosed. This organization also has support groups throughout the U.S. and Canada. The association has a presence on many social media platforms as well, including Facebook and Instagram.

The nonprofit Global Genes also offers a private discussion group for people with a variety of rare diseases. You can join the group to take part in community discussions, share personal stories, and connect with others who might have a sense of what you're going through.

Managing a long-term disease can be costly, even if you have health insurance. The PDSA offers an online booklet of frequently asked questions about health insurance and assistance programs for people with ITP. The association also highlights resources like the FundFinder financial-assistance search tool and the NeedyMeds treatment and health care cost-savings program.

Meanwhile, NORD (National Organization for Rare Disorders) offers patient assistance programs that may be able to help out with caregiver aid or financial assistance. And Global Genes has a list of financial resources.

Living with a rare condition like ITP can be very stressful. Over time, this can take a toll on your mental health – and the mental health of loved ones and any caregivers you have. The symptoms of ITP, treatment side effects, and uncertainty over the course that the disease will take can lead to anxiety, depression and exhaustion.

If feelings of fear, sadness, or stress start getting in the way of your daily life, think about having a candid talk with your doctor. You can ask them for medicine that may help or for a referral to a mental health professional, like a therapist. If you want to meet with a mental health professional, try to find one who has experience treating people with rare diseases or chronic illnesses. Along with giving you talk therapy, they also may teach you relaxation techniques like meditation, guided imagery, self-hypnosis, breath work.

You can also look over Global Genes' list of mental health resources.

Caring for someone with ITP can be almost as stressful as having the condition yourself. You have to juggle your own responsibilities, like career and family, while taking care of a loved one with a chronic condition.

To avoid burnout, make sure to also take care of yourself. Tips include:

  • Eat a well-balanced diet.
  • Get enough sleep.
  • Exercise at least five days a week.
  • Use healthy stress relief techniques like meditation or writing in a journal.
  • Spend time with your friends.
  • Take time to focus on yourself. 

The PDSA also offers support services for caregivers. The Caregiver Action Network and Lotsa Helping Hands are other organizations that offer caregivers assistance.

An ITP diagnosis could make you wonder about your future. Will this disease be with you for a lifetime? Could it shorten your life? Everyone's condition is unique, but overall, ITP has a good outlook thanks to improved treatments.

Can ITP be cured?

There is no cure for ITP. But corticosteroids and other medicines increase platelet counts and improve symptoms in most people.

ITP is a rare blood disorder that causes low platelet counts and an increased risk of bruising and bleeding. Chronic ITP can last for many years, and you may have to stay on treatment for the long term to prevent complications like severe bleeding. Corticosteroids are the main treatment for ITP. If they don't work, medicines that increase platelet production or stop your immune system from attacking platelets may help.

Is ITP a serious disease?

For most people, ITP isn't serious. Acute ITP often goes away on its own in a few weeks or months. Chronic ITP can last for many years, but there are treatments to boost platelet counts and prevent bleeding and bruising. Most people can eventually stop the medicine and still maintain a healthy platelet count.

What autoimmune diseases are linked to immune thrombocytopenia?

Autoimmune diseases are one possible cause of secondary ITP. Lupus, antiphospholipid antibody syndrome (APS), Hashimoto's disease, and Evans syndrome are some of the autoimmune diseases that cause ITP.

Is ITP related to leukemia?

ITP and leukemia both affect blood cells. ITP may be confused with leukemia because they have similar symptoms, but it's not cancer. ITP doesn't turn into leukemia, but people with chronic lymphocytic leukemia (CLL) are more likely to have ITP. 

Add WebMD as a Preferred Source to see more of our trusted content across Google Search, AI Overviews, and AI Mode 

Print
View privacy policy, copyright and trust info
View privacy policy, copyright and trust info