Idiopathic Thrombocytopenic Purpura

Alternate Names : Autoimmune Thrombocytopenia, ITP

What are the treatments for the disease?

If a person with ITP is hemorrhaging severely, the first treatment will be a transfusion of platelets. In some cases, the platelet count returns to normal on its own. This spontaneous remission of the disease is more common in children with ITP and rare in adults.

Corticosteroids, such as methylprednisolone or dexamethasone, are given to suppress the immune response. These can be given either intravenously or as tablets to be taken orally.

If steroid therapy does not improve the platelet count, more aggressive interventions can be tried. These include using intravenous immunoglobulin, also called IVIG. IVIG binds the autoantibodies that are attacking the platelets and removes them from the system. Once they are removed from the bloodstream, they cannot destroy the platelets. This treatment is very expensive and requires intravenous administration of medication.

To remove the autoantibodies causing the disorder, the person's blood can be filtered using a technique called plasmapheresis. A large catheter is placed into a blood vessel, and the blood is filtered through the plasmapheresis unit, removing the autoantibodies. This treatment is usually reserved for severe cases of ITP.

A splenectomy, or removal of the spleen, can be performed. Often this will cure the condition. Other experimental treatments have been tried with varying results.

What are the side effects of the treatments?

Medications used to suppress the immune system may cause allergic reactions or increased risk of infection. Surgery can cause bleeding, infection, and allergic reaction to the anesthesia.

What happens after treatment for the disease?

Treatment of ITP continues until a normal platelet count is restored. Then, the platelet count is monitored, and treatment can begin again if the platelet count begins to fall.

How is the disease monitored?

ITP is monitored by repeated complete blood counts, or CBCs. Any new or worsening symptoms should be reported to the healthcare provider.