What Are the Symptoms of ITP (Immune Thrombocytopenia)?

Immune thrombocytopenia (ITP) is a disorder in which the immune system inappropriately sees platelets as foreign in the body and destroys them. Platelets are a type of blood cell made in the bone marrow with the job of helping the blood to clot, stop bleeding, and heal blood vessel walls.

In ITP, platelets are destroyed, causing the total number of platelets in the blood to decrease. Decreased platelets can lead to bleeding or bruising.

Learn more about ITP symptoms.

Closeup of woman with bruised leg

Francesca Dagrada / EyeEm / Getty Images

Excessive Bruising

When platelet counts in the blood are low, excessive bruising may occur, as there are not enough platelets to quickly stop bleeding.

These bruises are called purpura. Minor trauma, such as bumping the skin, may cause a bruise to develop. Some bruising may develop without any known injury or cause.

Red Spots on Skin

Red spots that develop on the skin are called petechiae. These are tiny, pinpoint dots of bleeding under the skin. They typically appear in groups, may look like a rash, and are caused by broken blood vessels under the skin.

Low platelets from ITP do not allow the blood vessel wall to stop the blood from leaking.

Bleeding From Nose or Gums

Due to low platelets, bleeding may also occur from the gums in the mouth or from the nose.

Activities that normally do not cause bleeding, such as brushing the teeth or blowing the nose, may cause bleeding in someone with ITP. Small blood blisters in the mouth may also be seen.

Unusually Heavy Menstrual Flow

Women with ITP may experience heavier than normal bleeding during a menstrual cycle. This may be experienced by periods lasting longer than normal or by heavier flow during the menstrual cycle.

Blood in Urine, Stool, or Vomit

Blood that is found in the urine, stool, or in vomit may be a sign of internal bleeding.

Although rare, bleeding may occur in the:

  • Kidneys
  • Urinary tract
  • Stomach
  • Intestines 


A lump or firm, raised area called a hematoma may develop when there is significant bleeding under the skin. This lump is a collection of clotted or partially clotted blood under the skin. 


Fatigue in someone living with ITP can be due to multiple reasons:

  • If they are experiencing bleeding, they may have tiredness and exhaustion from anemia.
  • There may also be an underlying autoimmune disorder that has led to the development of ITP that may also cause fatigue. 

Bleeding From Head

It is very rare for someone with ITP to experience a bleed in the brain. However, there is a potential risk this could happen.

Symptoms of this would be similar to stroke symptoms, such as:

  • Facial drooping
  • Vision changes
  • Confusion
  • Weakness to one side of the body
  • Headache

When to See a Doctor or Go to the Hospital

Emergency treatment should be sought out for any bleeding that cannot quickly be stopped or is severe. If stroke-like symptoms present, these should always receive immediate medical treatment. 

Evaluation by a medical professional should be sought when excessive bruising, petechiae, or any other symptoms as listed above are present without a known cause. 


Immune thrombocytopenia (ITP)—a disorder in which the immune system inappropriately sees platelets as foreign in the body and destroys them—can have many different symptoms. If you experience any ITP symptoms, it’s important to seek medical care.

Frequently Asked Questions

  • What are the symptoms of ITP?

    Symptoms of ITP may include:

    • Unusual bleeding
    • Excessive bruising
    • Fatigue

    It is possible for ITP to cause no symptoms at all.

  • What are the symptoms of chronic ITP in children?

    The symptoms of ITP in children are similar to the symptoms of ITP in adults. In most children with ITP, the condition resolves within a year, sometimes without treatment. When ITP does not resolve—either spontaneously or with treatment after 12 months—it is called chronic ITP.

  • How does ITP make you feel? 

    ITP may make someone feel tired or worn out. It is possible that a person living with ITP doesn’t feel any differently than they normally do. 

  • How can I reduce the symptoms of ITP?

    Improving the symptoms of ITP generally occurs following treatment of ITP. The goal of treatment is to improve platelet counts, and when platelet counts increase, symptoms improve or resolve.

  • Do ITP and MDS (myelodysplastic syndrome) have the same symptoms?

    There may be some overlap of symptoms in ITP and MDS, especially with low platelet counts, bleeding, bruising, or fatigue. However, with MDS, other types of cells such as white blood cells and red blood cells may be low, and these would cause additional symptoms such as weight loss, fever, frequent infections, and bone pain.

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. National Heart, Lung, and Blood Institute. Immune thrombocytopenia.

  2. Cleveland Clinic. Immune thrombocytopenia.

  3. Cleveland Clinic. Abnormal menstruation (periods).

  4. Platelet Disorder Support Association. Living with ITP.

  5. Seattle Children’s Hospital. Immune thrombocytopenia.

  6. American Cancer Society. Signs and symptoms of myelodysplastic syndromes.

By Julie Scott, MSN, ANP-BC, AOCNP
Julie is an Adult Nurse Practitioner with oncology certification and a healthcare freelance writer with an interest in educating patients and the healthcare community.