What is purpura with thrombocytopenia? Julia Roberts’ illness

Few know that Julia Roberts has a blood disease. We tell you what the ITP that was diagnosed is about her.

What is purpura with thrombocytopenia?  Julia Roberts' illness

Last update: 03 November, 2022

For several years we have heard of the rare disease that Julia Roberts suffers. According to reports from her environment and from the statements of the actress herself, it is idiopathic thrombocytopenic purpura (ITP).

This blood and autoimmune disorder is not very common. In any case, it had become relevant since 2020 for being associated with an adverse effect of certain vaccines.

Of course, Julia Roberts’ illness was not triggered by a particular vaccination. Even so, when referring to the PTI for other reasons, the background of the actress usually comes up.

What is purpura and what is thrombocytopenia?

In medicine, we speak of purpura when there is a bruise on the skin or mucous membranes that measures between 4 mm and 10 mm. In other words, the term is used to describe a purplish spot that is formed by the outflow of blood from inside the vessels towards the skin.

These spots can be multiple or appear one at a time. Also, if you change the size, the denomination also changes. When they measure less than 4 mm they are no longer purple, but petechiae. Conversely, if they exceed 10 mm, they are ecchymoses.

Based on this definition, diseases causing hematomas between 4 and 10 mm were then classified. Actually, all spots up to 1 cm were included.

Thus, we can talk about the following clinical pictures:

  • Idiopathic thrombocytopenic purpura: is the disease that Julia Roberts suffers from. Some authors have proposed changing its name and calling it immune thrombocytopenia. We will describe it better later.
  • Thrombotic thrombocytopenic purpura: the mechanism of this disease is complex and can be fatal. What happens is that the platelets in the blood tend to stick together to form clots. They are capable of moving to vital organs, causing heart attacks or strokes.
  • Fulminating purple: It is a typical form of newborns. There is a lack of proteins necessary to control coagulation, so thrombi are formed that can obstruct circulation.
  • Senile purpura: It is a clinical presentation of older adults. It happens that the small blood vessels become more fragile due to aging and transude blood, forming visible bruises.
Hematomas are normal in moderate and severe trauma. If they appear with minimal hits, they should be studied.

And thrombocytopenia?

The term thrombocytopenia describes the situation in which a person has fewer platelets than is considered normal. Usually, between 150,000 and 400,000 platelets per microliter of blood is healthy.

When a patient has a platelet count of less than 150,000 in the laboratory, then thrombocytopenia is diagnosed. The causes are multiple and the situation is not a disease in itself, but a sign. This means that you have to look for the source of the problem.

Julia Roberts’ disease, ITP, is often suspected when a lab test accidentally discovers fewer than 150,000 platelets. Other common causes of thrombocytopenia are heavy metal poisoning, alcoholism, pregnancy, and cancer.



How is the idiopathic thrombocytopenic purpura?

In the ITP that Julia Roberts suffers from, there is an alteration of the immune system. The antibodies, which would have to defend us from external agents, begin to attack our own platelets. Then, these are destroyed and reduce their concentration in the blood.

With fewer platelets, the body cannot clot the blood as it should. Therefore, bruises or haematomas on the skin with minimal friction or minor trauma become frequent.

It is not yet clear why PTI is started. Cases have been identified that begin after ingesting antibiotics, after receiving vaccines or after having undergone both a viral (hepatitis) and bacterial infection (Helicobacter pylori).

Symptoms

Although it is purpura and bruising is the main manifestation of ITP, it is not the only sign. When bleeding occurs in the skin and mucous membranes, it is possible to find other manifestations.

Because women of reproductive age are usually the most affected, one symptom could be heavy periods. The body is unable to limit period bleeding.

Blood may also appear in the stool or urine. If the amount is not large, this presence sometimes goes unnoticed, until a fecal occult blood test or hematuria (for urine) is performed.

Finally, it can be suspected, especially in children, when there are nose bleeds that do not subside quickly. Despite taking steps to stop the bleeding, parents may find that the amount of blood is too much and that clotting is delayed.



Does Julia Roberts’ illness have a treatment?

Idiopathic thrombocytopenic purpura is confirmed with blood tests. In addition to verifying the reduction in platelets, the doctor may order antibody tests to detect those that could be involved in the autoimmune disorder.

However, if the disease is diagnosed as acute, it is expected to resolve itself in a maximum of 6 months. These are patients who will not require treatment, other than regular follow-up and check-ups.

Chronic conditions, which last beyond 6 months, are sometimes addressed actively, while in many others expectation is preferred. Namely, platelet levels are controlled to keep them in safe ranges, without prescribing medication.

The presence of anemia, heavy bleeding that complicates daily life or the risk of developing heart attacks or strokes, warrant the start of corticosteroids. Prednisone and dexamethasone are the most chosen. At the same time, monoclonal antibodies (rituximab) or platelet formation stimulators (romiplostim) can be added.

Platelet transfusion is reserved for patients with a very low count of the same and without response to medications. Similarly, the removal of the spleen or splenectomy is also reserved for treatments that do not come to fruition with the most basic measures.

The spleen produces antibodies and filters the blood. Their removal in ITP is done to reduce platelet loss.

What awaits Julia Roberts because of her illness?

The prognosis of ITP is good in most patients. This disease that Julia Roberts suffers from does not usually evolve in a torpid manner over the decades, except in specific cases.

The actress will likely just have to have regular platelet count tests. Perhaps she deserves to take some medication.

With due precautions, patients with ITP are able to lead a normal life, attending events and working. With sports, extreme care must be taken, since traumas that can generate large bruises must be avoided. In any case, physical exercise is not prohibited.

For now, Julia Roberts is still active. This year has launched journey to paradise and participate in the series Gaslit.

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