The 9-year-old patient named Ayan was diagnosed with immune thrombocytopenic purpura (ITP). Initially, he sought treatment from an allopathic doctor when his platelet count was recorded at 18000. In response, the doctor prescribed steroids, which led to an increase in his platelet levels to over 100,000. However, the situation recurred leading to the administration of steroids once more. It became clear that this was not a permanent solution. They sought further treatment at Sree Subramania Nursing Home upon arriving in November 2023, with a platelet count range of 30,000 to 33,000. Within three days of his admission, the patient developed a fever and noticed severe reddish round rashes on his palms and soles. Additionally, the patient experienced persistent itching and skin pealing which leaded to further irritation. Another issue he highlighted was the presence of pimples on his forehead and back. By September 2023, after a month of treatment at the nursing home, his platelet count began to show signs of improvement. During the course of treatment, it was revealed that the patient had allergies to certain substances such as prawns and chocolate, which were observed to correlate with fluctuations in his platelet count. He continues to undergo regular internal medication and follow-up appointments and presently maintains normal platelet and haemoglobin levels.
Internal medicine
26/12/23
- Vasaguduchyadi kashayam-30ml BD
- Kumaryasavam+sudarshanasarishtam-10ml TID
- Raktavridhi sindhooram-1 packet BD with ginger,lemon juice and honey
29/12/2023
- Ashtachoornam -1/2 tsp with ginger juice +sugar TID
- Madhukasavam-10ml+Deepani tablet-1/2 tab TID
01/01/2024
- Thaleesapathradi choornam-1/4 tsp 3-4 times
04/01/2024
- Amritarishtam+punarnavasavam-10ml TID
19/01/2024 (for 3 months)
- Vasaguduchyadi kashayan-30ml BD
- Rasayanarishtam-1 tsp BD
- Swarnabhasma capsule
- Ashtachoornam-1/4 tsp+1/2 tsp ginger juice +sugar(3-4 times)
- Amrutarishtam+punarnavasavam-10ml 3-4 times
- Mahatiktaka grita-External application
- Gudardrakam-frequent use
- Poshana hair oil-for head
- Taleesapathradi choornam-1/2 tsp 3-4 times
- Rasayanarishtam -1 tsp BD
13/04/2024
- Sudarshanam Gulika(1/2 tab 2-3 times)
- Amritarishtam+punarnavasavam
- Deepani tablet with ginger juice
- Sankha Bhasma 1 packet BD with honey
24/07/2024
- Vashaguduchyadi kashayam
- Abhraka Bhasma- 1 pinch
- Ashtachoornam-1/2 tsp with ½ tsp ginger juice
- Ikshu kalpa-1/2 tsp BD after food
- Pippalyadi Gulika-1/2 tsp BD with ginger juice
(Note* –
- Here are Some of the medications prescribed to address the patient’s accompanying symptoms.
- This is a specialized plan for a person, please do not try it at home without the supervision of an Ayurvedic Doctor)
| DATE | NAME OF TREATMENT |
| 24/12/2023 | dhanyamala dhara |
| 25/12/2023 | dhanyamala dhara |
| 26/12/2023 | kashaya dhara |
| 27/12/2023 | kashaya dhara |
| 28/12/2023 | kashaya dhara |
| 29/12/2023 | kashaya dhara |
| 31/12/2023 | dasamoola ksheeradhara |
| 01/01/2024 | dasamoola ksheeradhara |
| 02/01/2024 | dasamoola ksheeradhara |
| 03/01/2024 | dasamoola ksheeradhara |
| 04/01/2024 | dasamoola ksheeradhara |
| 05/01/2024 | dasamoola ksheeradhara |
| 06/01/2024 | dasamoola ksheeradhara |
| 07/01/2024 | dasamoola ksheeradhara |
| 08/01/2024 | dasamoola ksheeradhara |
| 09/01/2024 | dasamoola ksheeradhara |
| 10/01/2024 | dasamoola ksheeradhara |
| 11/01/2024 | dasamoola ksheeradhara+manjishtadi vasthi |
| 12/01/2024 | dasamoola ksheeradhara+manjishtadi vasthi |
| 13/01/2024 | dasamoola ksheeradhara+manjishtadi vasthi |
| 14/01/2024 | dasamoola ksheeradhara+manjishtadi vasthi |
| 15/01/2024 | dasamoola ksheeradhara+manjishtadi vasthi |
| 16/01/2024 | dasamoola ksheeradhara |
| 17/01/2024 | dasamoola ksheeradhara |
| 18/01/2024 | dasamoola ksheeradhara |
| 19/01/2024 | dasamoola ksheeradhara |
| 20/01/2024 | dasamoola ksheeradhara |
External treatment
Investigations
| Sl.no | Date | Hb value | Platelet value |
| 1. | 20/12/2023 | 11.4 | 108000 |
| 2. | 26/12/2023 | 12.3 | 155000 |
| 3. | 29/12/2023 | 13.5 | 110000 |
| 4. | 10/01/2024 | 13.2 | 247000 |
| 5. | 29/01/2024 | 6.5 | 27000 |
| 6. | 01/02/2024 | 5.8 | 28000 |
| 7. | 11/02/24 | 10.6 | 45000 |
| 8. | 17/02/2024 | 9.9 | 50000 |
| 9. | 25/02/2024 | 8.3 | 48000 |
| 10. | 03/03/2024 | 7.8 | 37000 |
| 11. | 06/03/2024 | 7.3 | 39000 |
| 12. | 23/05/2024 | 10.7 | 23000 |
| 13. | 06/07/2024 | 12.8 | 214000 |
Idiopathic Thrombocytopenic Purpura (ITP) is a bleeding illness in which the immune system attacks platelets, hence increasing the risk of bleeding and causing a temporary or persistent drop in platelet count. “Idiopathic” means of unknown origin. “Thrombocytopenia” is when there is a decreased number of platelets in the blood. “Purpura” refers to the skin turning purple, like a bruise.
Platelets are important for clotting. They gather at the injury, stick to the damaged blood vessel, and help form a clot that stops the bleeding.The normal range for platelet concentration is 150,000 to 450,000 per cubic millimeter. If the number of platelets is too low, it can cause internal or subcutaneous bleeding. This condition is more common in women than in men, occurring two to three times more often. Ongoing care is necessary as chronic ITP can recur frequently.
ITP can take two different forms:
- Acute thrombocytopenic purpura, which mainly affects children between the ages of two and six. Its signs and symptoms may be caused by a viral disease such as chickenpox. The symptoms of acute ITP usually appear very suddenly and disappear in less than six months, often in a matter of weeks. The disorder usually does not return.
- Chronic thrombocytopenic purpura, on the other hand, can appear at any age and its symptoms can persist for a long time.
Causes
The cause of ITP is often unknown. It’s not contagious, so one child can’t “catch it” from another child with ITP. It’s important to know that neither the parents nor the child caused the disorder. Sometimes, the child may have had a virus or viral infection about three weeks before developing ITP.
symptoms
- Purple skin discolouration (purpura) and bruises from the minor movement
- Nosebleeds
- Tiny red dots under the skin (petechiae)
- Bleeding in the mouth, around the gums and from the head
- Blood in vomit, urine or stool
Diagnosis
- A complete blood count (CBC)– to measure platelets.
- Additional blood and urine tests (if needed)- Measure bleeding time and detect possible infections
Treatment
In modern medicine, treatments such as steroids, intravenous gamma globulin, hormone therapy, and splenectomy are provided if needed. These treatments can help prevent bleeding by reducing the destruction of platelets, resulting in an increase in platelet counts within two to three weeks. However, long-term use of these treatments may lead to side effects such as irritability, stomach irritation, weight gain, hypertension, and acne.
In Ayurveda Bleeding disorders can be correlated with Raktapitha.Raktapitta (bleeding disorders) can be categorized into Urdhvaga, Adhoga, and Tiryakgata. These involve the pouring of polluted blood through upper passageways, leaking of blood through descending orifices, and subcutaneous manifestation due to vitiated doshas moving through the bloodstream. ITP and Tiryagata Raktapitta are connected due to their involvement in subcutaneous manifestation and blood vitiation.By strictly adhering to the medication and advice provided by our expert physicians at Sree Subhramania Ayurvedic Nursing Home, the best Ayurvedic hospital in Kerala for Immune Thrombocytopenic Purpura (ITP), we can confidently maintain a healthy platelet level without any symptomatic abnormalities.
