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Immune Thrombocytopenia Purpura

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by Dameron A

(Idiopathic Thrombocytopenic Purpura; ITP)

 

Symptoms

Both adults and children may notice the following symptoms:
 

Treatment

Treatment for ITP is different for children and adults. ITP is short term in most children. Most children will recover without any treatment. Adults are more likely to develop a chronic form of ITP. Not all of these chronic ITPs will require treatment. Talk with your doctor about the best plan for you.
Some treatment options include:

Medications

Medication may help to either slow the destruction of platelet cells or increase production of platelets. The overall goal is to maintain a healthy level of platelets in the blood.
To increase platelet counts in the blood, your doctor may recommend:
  • Steroids to lower the activity of the immune system. This will decrease the destruction of platelets.
  • Gamma globulin infusions to slow down platelet destruction. An infusion means that it is given by IV or through a shot. It usually works more quickly than steroids.
Both of these treatments work, but both can have side effects.
Two drugs are being used to stimulate platelet production:
  • Eltrombopag
  • Romiplostim
Use of these and a medication called rituximab may prevent the need for surgery.

Platelet Transfusion

A platelet transfusion may be used to prevent the platelet count from dropping too low.

Surgery

A splenectomy may be done if medication is not effective.
A splenectomy is the removal of the spleen. The spleen is the main site of platelet destruction. Without your spleen, your platelet levels should begin to improve. However, the missing spleen also makes you more likely to get certain infections. This surgery is usually not done until all medication options have been tried.

Activity Changes

You may be asked to avoid certain activities when your platelet counts are low. This may include avoiding contact sports or wearing a helmet.
 

RESOURCES

American Academy of Family Physicians
http://www.familydoctor.org

National Heart, Lung, and Blood Institute
http://www.nhlbi.nih.gov

 

CANADIAN RESOURCES

Canadian Medical Association Journal
http://www.cmaj.ca

Health Canada
http://www.hc-sc.gc.ca

 

References


Bussel JB; Cheng G; et al. Eltrombopag for the treatment of chronic idiopathic thrombocytopenic purpura. N Engl J Med. 2007 Nov 29;357(22):2237-2247.


Immune thrombocytopenia (ITP). EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated March 28, 2013. Accessed July 11, 2013.


George JN, Woolf SH, et al. Idiopathic thrombocytopenic purpura: a practice guideline developed by explicit methods for The American Society of Hematology. Available at: http://www.ouhsc.edu/platelets/itp/ITP%20Publications/pub2%5F1.pdf. Accessed July 11, 2013.


Karpatkin S. Autoimmune (idiopathic) thrombocytopenic purpura. Lancet. 1997;349:1531-1536.


Newland A, Caulier MT, et al. An open-label, unit dose-finding study of AMG 531, a novel thrombopoiesis-stimulating peptibody, in patients with immune thrombocytopenic purpura. Br J Haematol. 2006 Nov;135(4):547-553.


What is immune thrombocytopenia? National Heart Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/itp/. Updated March 14, 2012. Accessed July 11, 2013.

 

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