Idiopathic Thrombocytopenic Purpura (ITP) | Treatment

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How is ITP treated in adults?

Mild cases of ITP may not require treatment, just regular monitoring of the platelet levels.

Otherwise, treatment of ITP in adults is aimed at increasing the blood platelet count. This is not the same as curing the disease. Your doctor may recommend that you get high doses of immune globulin (through a needle). Some patients might take prednisone for several weeks or months. Prednisone raises the level of your platelet count. As your count rises and reaches a safe level, your doctor may gradually decrease your medicine until you no longer take the prednisone. However, when the medicine is stopped, your platelet count may decrease again.

If prednisone doesn't help enough, your doctor may recommend that your spleen be removed. The spleen makes most of the antibodies that destroy the blood platelets. It also destroys old or damaged blood cells. In an otherwise healthy person, removal of the spleen is not a serious operation. Laparoscopic removal of the spleen is now possible, further reducing surgical risk. However, this treatment is done less often than it once was. Removing the spleen will permanently reduce your body’s ability to fight infection. Some people can also relapse (have the condition return) even after the spleen is removed.

Other treatments for ITP include another kind of steroid medicine called danazol or other medicines that work to hold the immune system in check, such as rituximab. Some people with certain blood types may have anti-RhD therapy, which is a shot or series of shots that also work to reduce antibodies in the blood. Another option includes filtering antibodies from the blood.

How is ITP treated in children?

Because most children recover with no treatment, many doctors recommend just watching them carefully and taking care of the bleeding symptoms. Children don't have to go to the hospital if good care is available at home. However, some doctors recommend a short treatment with prednisone pills or intravenous infusions (given in a vein) of gamma globulin to increase the platelet count more quickly. Both medicines have some side effects.

What can I do if I have ITP?

If you have ITP, you should avoid medicines that increase risks for bleeding, such as warfarin (a medicine often used to treat an abnormal heart rhythm called atrial fibrillation) and over-the-counter drugs like aspirin and ibuprofen (some brands: Advil, Motrin). You should also limit alcohol because it can decrease the ability of your blood to clot.

Written by familydoctor.org editorial staff

Reviewed/Updated: 03/14
Created: 09/00

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