Idiopathic thrombocytopenic purpura (ITP) Treatment Question

Patient

Q: My friend has been sick with flu-like symptoms for about two weeks. He recently began to have small red spots on his body, and also began to get sores in his mouth that are bleeding. We went to the emergency room, and his platelet level was less than 10,000 -- the doctor told him he probably has ITP and gave him a prescription for predisone and discharged him. Are there any other treatments that would be more appropriate than just steroids for his low platelet count?

Doctor

A:   Idiopathic thrombocytopenic purpura (ITP), is a blood clotting disorder that can lead to easy or excessive bruising or bleeding as a result of very low levels of platelets.  The exact cause of ITP is not known. It is thought that the immune system malfunctions and begins attacking the platelets in the body. The goal of treating ITP is to ensure a safe platelet count and prevent bleeding complications while minimizing treatment side effects. Your doctor is right in prescribing your friend prednisone. Your friend will also require regular monitoring and platelet checks. If prednisone fails in the treatment, other treatment options available are Intravenous immune globulin (IVIG) and Thrombopoietin receptor agonists. If his condition worsens even with treatment surgery (splenectomy) may be the last resort.

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