blood disorders
Immune Thrombocytopenia (ITP)
Treatment of ITP
Corticosteroids Intravenous immunoglobulin, thrombopoietin receptor agonists, or immunosuppressive drugs (for example,rituximab,azathioprine, ormycophenolate) Sometimes, removal of the spleen Rarely, platelet transfusions In ITP, the antibodies that destroy platelets can be blocked temporarily with a corticosteroid (for example,prednisone) or intravenous immune globulin, allowing the number of platelets to increase. Children usually recover within several weeks to months after this treatment. About a third of adults recover during the first year, but most do not. Adults who do not respond adequately to corticosteroids or are dependant on corticosteroids may require additional drugs that increase platelet production (thrombopoietin receptor agonists) or suppress the immune system, includingrituximab,azathioprine, cytoxan,cyclosporine, ormycophenolate.Fostamatinibis another drug that can be used if other drugs are not helpful. The thrombopoietin receptor agonists (such asromiplostim,eltrombopag, andavatrombopag) increase the rate of platelet production and may be effective for years. These drugs are especially useful for people who are not able to undergo (or are unwilling to undergo) splenectomy. Some adults (but usually not children) with ITP benefit from surgical removal of the spleen (splenectomy). Because the spleen removes abnormal platelets from the bloodstream, removing the spleen sometimes increases the number of platelets. Downsides to splenectomy include an increased risk of blood clots, increased risk of cancer, and increased risk of certain life-threatening infections such as Pneumococcal Infections . People who undergo splenectomy may be given certain antibiotics or vaccines that lessen (but do not totally eliminate) the infection risk. Drug treatment is increasingly being used instead of splenectomy. People with life-threatening bleeding may be given a platelet transfusion (in addition to intravenous corticosteroid and/or immune globulin). 