First, and unfortunately, ITP is so rare and is barely known by any of the MDs. I've had several Hematologists/Oncologists, and out of all of them they were lucky if they had one other single ITP Chronic patient. ITP can be acutely caused by an infection, or H. Pylori in the gut from raw fish. Japanese get it much more than Westerners. If you are young under 50 and no family history of chronic Immune diseases like Lupus, Socratic Arthritis, and others blood disorders, etc. You may just be temporarily down due to even a drug or med you take regularly like chronic Ibuprofen takers which can destroy your platelets. I have a young cousin who in her twenties took Ibuprofen everyday over the counter and had her platelets down into the 20s. They recovered once she got off the Motrin, etc. The most surefire way to know is prolonged platelets in the low numbers, and a bone marrow biopsy which shows if your bone marrow is producing platelets normally, but something else like your immune system is destroying them prematurely. If you do ever have a biopsy done, and the Dr. works in the local very well before he begins, it's a painless test. Felt nothing but him pressing down on my back a bit. My mother's side of the family has extensive immunology problems, and unfortunately, I have inherited as well. We all have different chronic severe conditions. Hopefully, if you have ITP yours will be milder and more manageable. Mine is severe, and I only have one drug that works for me after having tried all the others. Nplate its called which boosts platelet production in my marrow (though mine was still normal) thereby outnumbering and overwhelming my destruction rate. NPlate = Attrition: So many produced my immune system cant deplete them fast enough, but I got a huge spike in my platelets last month above 970, and got a blood clot in my lower Aorta that also went to my lower leg. Had to have a stent placed to trap the Aortic clot, and have my leg opened up to relieve swelling from Compartment Syndrome, or they would have had to amputate my leg. As I'm sitting here, my leg is still open incision 3"x7 " long. 8 more weeks, until it should be finally closed. ITP can be fairly mild and manageable for many or even most, but I'm on the extreme end of the spectrum. For some it even vanishes if you're younger. I have been on every kind of ITP specific medication to date now including the latest 2018 Tavilise, which has failed me. It worked for two weeks then nothing. Steroids and NPlate are all that continue work for me long term. I've had IVIGs, Rituxin chemo drug (worked one time for 16 months then never again after two more tries with it). Promacta did nothing for me either. I do still have my spleen ( being talked about now - they throw stuff at the wall to see if anything is left for me that sticks at this point). Spleen removal is only effective in like 24% of those who elect it. Spleen is primarily where the platelets get destroyed, or sucked up. It's the oldest treatment when they discovered it in like 1920, etc. It can fully cure some but not many, but you forfeit your immune system losing your spleen. Some statistics will say you are more likely to die from Pneumonia or infections after a Splenectomy than from ITP FOR MOST. It's been a very rough and aggressive diseases I never had any input to choosing in my life. Don't let me discourage you. Most have milder situations that can usually be managed with the existing ITP meds. There are so few of us, that it's very hard to get funding to find a cure, or a really good drug. It's not a money maker drug like Viagra, or they'd funded it and figured it out long ago. There are only like 40,000 females in the US chronic, and 20,000 males chronic. 60-70k population reporting Chronic ITP, so it's rare and not much research money base, except for the US govt declaring it an orphan disease to get some small grants for it to research a little, etc. As for me, I may be heading toward more aggressive forms of imunosupressive treatments like cancer patients transplant recipients. etc. to destroy parts of my immune system or suppress them from killing my platelets. Getting to that phase it seems. Don't be discouraged though, like I said, I'm the extreme end of the spectrum now. Wish you the best. Regards
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