Immune Thrombocytopenic Purpura in The Elderly

September is National Immune Thrombocytopenic Purpura Awareness Month. Commonly known as ITP, this immune disorder is characterized by abnormal clotting of the blood, which can cause hemorrhaging if someone suffering from it gets a cut or an injury; they will also bruise easily, and have an increased risk of infection. While this condition can develop at any age, elderly people are more likely to be affected by chronic ITP – so in order to live a longer, healthier life, find out if you are at risk for immune thrombocytopenic purpura by knowing its risk factors, signs and symptoms. 

What Is Immune Thrombocytopenic Purpura?

blood platelets flowing
ITP happens when you have a low blood platelet count.

Immune thrombocytopenic purpura means you have a low number of blood cell fragments called platelets, or thrombocytes. Normally, these platelets are made in your bone marrow along with other kinds of blood cells, and they stick together to help heal cuts or breaks in blood vessel walls to help stop bleeding; if you suffer from ITP, however, your body does not produce enough platelets, and you are more susceptible to bleeding both internally and externally. Not only that, but immune thrombocytopenic purpura actually causes your immune system to mistakenly attack and destroy your body’s platelets.

Risk Factors

ITP is not contagious and cannot be passed from one person to another. It can occur at any age, but generally acute ITP is more common in children and lasts less than 6 months, and chronic ITP is more common in adults, and lasts 6 months or longer. In children, the condition usually develops after a virus, while in adults, it usually develops over time. Elderly patients will have an increased bleeding risk compared to those who are younger, and will be more prone to thrombotic complications.

Factors that can decrease platelet production include:

  • Leukemia and other cancers
  • Anemia
  • Viral infections, such as Hepatitis C or HIV
  • Chemotherapy drugs
  • Radiation therapy
  • Heavy alcohol consumption

Symptoms

blood splatters
Prolonged bleeding from cuts is a symptom of ITP.

ITP doesn’t always have very noticeable signs or symptoms, but it will cause bleeding inside and outside of the body. Things to look out for are:

  • Purple bruises, or purpura, on the skin, which are caused by bleeding from small blood vessels.
  • Petechiae, or pinpoint, round spots that appear in clusters
  • Nosebleeds
  • Bleeding from the gums
  • Blood in urine or stool
  • Prolonged bleeding from cuts
  • Clotted blood under the skin that looks or feels like a lump

How Is It Diagnosed?

If you or your doctor suspect you have immune thrombocytopenic purpura, your doctor will:

  • Conduct a physical exam to look for signs of bleeding and infection.
  • Run diagnostic tests- Blood work will be done to evaluate your liver and kidney function and check your platelet count; your doctor might also do a blood test to check for antibodies that are attacking your platelets. 
  • Bone marrow test- If the blood test shows that your platelet count is low, a bone marrow test will be done to determine whether your bone marrow is making enough platelets. If your bone marrow is not producing enough platelets, you are most likely suffering from another issue, such as a bone marrow disease or cancer.
  • Imaging tests- Ultrasound or CT scans can check for an enlarged spleen, enlarged lymph nodes, or cirrhosis of the liver.

Treatments

Your doctor will determine your treatment based on the total number of platelets you have, as well as how often and how much you bleed. If you are older, they will want to monitor your platelet and red blood cell count, because a low red blood cell count can be a sign of internal bleeding, which will put you at risk for spontaneous bleeding in the brain and other organs. Some forms of treatment include:

  • Medications- This is often the first course of treatment. You will be prescribed corticosteroids, or steroids, such as prednisone, which will help increase your platelet count. Your doctor might also prescribe treatment given by injection, such as rituximab, immune globulin, or anti-Rh (D) immunoglobulin.
  • Splenectomy–  If the above medications don’t work for you, your doctor might order surgery to remove your spleen, an organ located in the upper left abdomen that makes antibodies that help fight infections. A splenectomy can help reduce the destruction of platelets, but it is important to note that the surgery will raise your risk of infection, so your doctor will explain what steps to take to avoid this side effect.
  • Platelet transfusions–  If you have severe bleeding, you might need a platelet transfusion to increase your platelet count, but this is only a short-term solution.

Lifestyle Changes

There are some steps you can take to help increase your platelet count, including:

different medication pills lined up next to each other

  • Avoiding certain medications- Some medicines can lower your platelet count or cause bleeding, such as aspirin and ibuprofen. 
  • Limiting your intake of alcohol, because it can affect blood clotting.
  • Participating in low-impact activities, such as swimming, biking with a helmet, and walking, in order to decrease your risk of injury and bleeding.

Immune thrombocytopenic purpura is a disease for which there is no known cause or cure, but know that if you have ITP,  you can live for many decades with the disease, even if you have a more severe form of it. The best way to live a long, healthy life is by recognizing the symptoms of ITP, getting checked, staying on top of treatments, and making lifestyle changes. Medicare Parts A and B will pay for treatment and medication, but Part B will only pay for 80% of your expenses, leaving you to pay the remaining 20% out-of-pocket. That 20% can really add up, but if you have a Medicare Supplement Plan, your plan will cover many of these costs. 

There are 10 different Medicare Supplement Plans to choose from, so it’s important to compare each one and find the plan that suits  your medical needs and saves you money. EZ agents work with the top-rated insurance companies in the country and can compare plans for you in minutes, at no cost to you. To get free instant quotes, simply enter your zip code in the bar above, or to speak to a licensed local agent, call 888-753-7207. No hassle or obligation!

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