Q: Up until 20 years ago, I donated blood regularly and had no problems doing that. At that same time, I was diagnosed with an acute case of idiopathic thrombocytopenia purpura. Well, I spent time in the hospital, was on prednisone, and a few mild episodes followed. At that time my hematologist advised that I should not give blood but that was a long time ago. Now when I see pleas for blood donors, I wonder if I can donate once again. I know it won’t bother me, but I don’t want to go through the donation process if they won’t use my blood based on the fact that I’ve had a blood disorder in the past.
Any stats you may be able to find on the chances I will have a recurrence of IPT would be appreciated. I am a 48-year-old female Caucasian. My only health issues have been gestational diabetes, high cholesterol for which I take a statin and back surgery seven years ago for a herniated disk.
A: ITP results from low platelet levels, the cells that help blood clot. The condition can lead to easy bleeding and bruising. Individuals of all ages can develop ITP. When it occurs in children, it is often following a viral infection, with the child most commonly recovering completely without treatment. However, when an adult develops ITP, the disorder may be chronic.
Symptoms may include spontaneous nosebleeds, purpura (excessive bruising), gums that bleed following hard brushing or dental work, blood in the stool, fatigue, and more. The treatment provided provided will depend on a person’s age, his or her platelet count, and symptoms that present. Serious cases may respond well to medication, while more extreme cases may require surgery.
While the exact cause for ITP isn’t fully known or understood, it is known to be a malfunction of the immune system that incorrectly attacks platelets. Antibodies are produced by our immune system. They attach to platelets and earmark them for destruction. The spleen recognizes those antibodies and removes the platelets from the system, resulting in a case of mistaken identity . A normal platelet count is commonly higher than 150,000 per microliter of circulating blood. The individual with ITP may have a count lower than 20,000 and when that number falls below 10,000, the risk of internal bleeding is elevated dramatically. In fact, an internal bleed is the greatest problem known – particularly when it occurs into the brain.
Depending on the severity of each case, medications such as corticosteroids should help raise the platelet count. Hopefully the first round will be effective, since the long-term use of steroids comes with its own set of issues. Other treatment might include intravenous immune globulin, thrombopoietin receptor agonists, biologic therapy and ultimately splenectomy which is removal of the spleen.
When it comes to blood donation, because it has been so many years and I am interpreting your platelet count is now normal, and because the problem is idiopathic, meaning there is likely no known cause for the occurrence, you may be able to donate. However, there are differing schools of thought on the subject. Sloan Kettering indicates an individual may donate if he or she had a history of ITP as a child (prior to the age of 11) with no residual effects. Another source, however, indicates you cannot because you may have antibodies that would effect other platelets in the recipient’s blood. I recommend you speak with the Red Cross center nearest you for clarification. Good luck.
