ITP Treatment Options
Many children with ITP do not need treatment. It often goes away on its own in a few weeks or months.
For more serious cases, your child’s provider may recommend treatment. This will not cure ITP, but it will help your child make more platelets and slow down the speed that platelets get destroyed. Here are the main ITP treatment options:
Intravenous gamma globulin (IVIG)
IVIG is made from blood plasma. It may help block the antibodies that cause platelet destruction. It is given into the vein over several hours. IVIG can cause nausea, headache, and other side effects.
This is also made from blood plasma. It causes the spleen to destroy some of your child’s red blood cells instead of platelets. This medicine may cause a temporary drop in red blood cells (anemia), but may help to raise the platelet levels. It is given into the vein over about 15 minutes. Your child’s healthcare team will watch your child for several hours after treatment.
These medicines may help slow down the speed that the spleen takes platelets out of the blood. They are usually taken by mouth. Steroids, like prednisone or dexamethasone, have several side effects. They make your child gain weight, feel hungrier than usual, have an upset stomach or feel moody. If your child gets this treatment, their provider will talk with you about how to manage side effects.
Taking out the spleen (splenectomy)
For some very serious or long-lasting cases of ITP, healthcare providers might recommend a splenectomy. This surgery has long-term effects, so it is important to talk with your child’s medical provider about what to consider and what to expect.
Other medicines are sometimes used for ITP, especially when it is very serious or chronic. Your child’s provider may talk with you about these if your child may need them.
Many people wonder about using transfusions as a treatment. We almost never use platelet transfusions in ITP treatment because the transfused platelets are destroyed by the spleen as quickly as the child's own platelets.
Your child’s provider will talk with you about when and how often your child’s platelet count should be checked. Right after treatment for ITP, we will check your child’s platelet count often (every two to three days). If there are no problems, we may check weekly for the next month. After that, we will check less often. When the platelet count is normal and stable, we can stop checking platelet levels.
If your child does not need treatment, or if they have ITP longer than four to six weeks, they may not need to be checked so often. But if your child develops new symptoms or has problems like bruising again, that is usually a time to check the platelet count.
Your child’s provider will talk with you about the plan to monitor your child. This plan will depend on your child’s individual needs. We will work with you and with your primary care provider to decide where to have those blood tests done and whom to talk to about the results.