Due to a low platelet count, blood clotting doesn't occur normally in people with idiopathic thrombocytopenic purpura (ITP). The destruction of platelets by the immune system is the cause of this problem, and it can lead to such complications as abnormal bleeding and bleeding under the skin.
ITP affects more women than men and is often chronic in adult cases, but when present in children, it is usually temporary. Here is a look at some treatment options for this condition, depending on the patient's age and severity of the disorder.
Medications
The first step for treatment is most likely medication prescribed by a doctor for both children and adults. The medications include:
- Corticosteroids: This medication decreases activity of the immune system, thus increasing platelets. Corticosteroids can be tapered off once improvement in platelet count is seen, usually in two to six weeks. However, relapse is possible and common once treatment ends. However, long-term use of corticosteroids is discouraged because of the complications that can arise, such as osteoporosis, cataracts, muscle atrophy, risk of infection, high blood sugar, and diabetes.
- Thrombopoietin receptor agonists: This medication improves the bone marrow's production of platelets, which helps prevent bruising and bleeding. Side effects include headache, joint and muscle pain, dizziness, nausea or vomiting, as well as a risk of blood clots.
- Intravenous immune globulin (IVIG): IVIG is a treatment option for those with severe bleeding or those who need a quick boost in platelet count for surgery. This treatment is effective but causes side effects such as headache, nausea, and fever.
Surgery
In severe adult cases of ITP, surgical removal of the spleen is an option. The procedure is called a splenectomy. Removing the spleen is done in hopes to improve platelet count, because the spleen is responsible for damaging platelets. However, the spleen is needed to fight infection, so removing the organ can increase risk of infection or becoming ill. A doctor should be notified at any sign of fever or infection if the spleen has been removed.
Emergency Treatment
In rare cases of severe bleeding, emergency treatment is needed, such as a transfusion of concentrated platelets, intravenous methylprednisolone, or intravenous immune globulin. These treatments effectively, but temporarily, raise the platelet count to help slow down or stop bleeding. A person may also receive a platelet transfusion before surgery to help the incision heal.
