Recently leaders from the ITP
community met to talk about
diagnosis, treatment,
developments and challenges
surrounding ITP.
This dialogue is part of a series
sponsored by CSL Behring for
patients, caregivers and
healthcare professionals in the
communities we serve. |
|
Left to Right: Dr. Douglas Cines, Joan Young, Dr. Garrett Bergman and Dennis Jackman
Dennis Jackman: What is ITP?
Dr. Douglas Cines: ITP is a bleeding disorder caused by a reduction in platelets—the circulating cells that help prevent bleeding. ITP is an abbreviation for idiopathic thrombocytopenic purpura, which technically means a condition of unknown origin manifested by a low platelet count and red or purple discolorations of the skin. ITP is also an abbreviation for immune thrombocytopenic purpura since most cases of ITP result from an antibody response against platelets. Both terms are accurate. In ITP, antibodies react with the patient’s own cells and lead to their removal from circulation—and in some cases, a reduction in their production. When the platelet count in the bloodstream falls to a certain level stressing the vascular system, internal bleeding can ensue.
Dennis: How common is ITP?
Doug: It’s very difficult to know. We estimate that approximately five in 10,000 adults and children have the disorder; therefore, about 100,000 people in the United States are afflicted. This statistic may, however, underestimate the prevalence of the disorder because patients who have the disease, but have been successfully treated, are no longer counted, and, alternatively, patients who have the disease but are not afflicted have never been counted.
Dennis: Why is it so hard to come up with an accurate number?
Doug: Partly it’s the criteria for making this diagnosis, and partly it’s the reporting of the disease through coding procedures. There are inherent difficulties in coding, for instance. How many low platelet counts does it take until the diagnostic code used in the ICD-10 (International Classification of Diseases, 10th edition) becomes ITP? Not all patients with low platelet counts have ITP. Also, it’s difficult to keep track of medical disorders in many countries, especially the United States. We don’t have registries for this condition.
Dr. Garrett Bergman: And there are some patients who have ITP and don’t have symptoms that would cause them to see a physician—cases that may remain undiagnosed until the patient has a catastrophic hemorrhage
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A Diagnosis of Exclusion |