How Is Idiopathic Thrombocytopenic Purpura Treated?
Treatment for idiopathic thrombocytopenic purpura
(ITP) is based on how much and how often youre bleeding and your platelet
count. Medicines are often used as the first course of treatment. Treatments
used for children and adults are similar.
Adults with ITP who have very low platelet counts or
problems with bleeding are usually treated. Adults who have milder cases of ITP
may not need any treatment, other than monitoring their symptoms and platelet
counts.
The acute (short-term) type of ITP that occurs in
children often goes away within a few weeks or months. Children who have
bleeding symptoms, other than merely bruising (purpura), are usually treated.
Milder cases in children may not need treatment other than monitoring and
followup to be sure platelet counts return to normal.
Medicines
If treatment is needed for adults or children who
have ITP, medicines are usually used first. Corticosteroids
(cor-ti-co-STEER-roids), such as prednisone, are commonly used to treat ITP.
These medicines, called steroids for short, help raise the platelet count in
the blood by lowering the activity of the immune system. However, steroids have
a number of side effects, and some people relapse (get worse) when treatment
ends.
Some medicines used to help raise the platelet count
are given through a needle in a vein. These medicines include immune globulin
and anti-Rh (D) immunoglobulin.
Experimental medicines may be tried if these
treatments dont help. Medicines may be used along with a procedure to
remove the spleen, called splenectomy (splee-NECK-tuh-mee).
Removal of the Spleen (Splenectomy)
If necessary, the spleen will be removed surgically.
This organ is located in the upper left abdomen and is about the size of a golf
ball in children and a baseball in adults. If ITP hasnt responded to
steroids, removing the spleen will reduce the destruction of platelets, but it
also may make you more likely to get certain types of infections. If your
spleen is removed, discuss with your doctor steps you can take to help avoid
these infections and the symptoms to watch out for.
Other Treatments
Platelet Tansfusions
Some people with ITP who have severe bleeding may
need to have platelet transfusions and be hospitalized. Some will need a
platelet transfusion before having surgery. For a platelet transfusion, donor
platelets from a blood bank are injected into the recipient's bloodstream to
increase the platelet count for a short time.
Treating Infections
Some types of infections can briefly lower a
persons platelet count. If a person with ITP has an infection that can
lower the number of platelets, treating the infection may help raise the
platelet count and reduce bleeding problems.
Stopping Medicines
If a person who has ITP is taking medicine that can
lower the number of platelets or cause bleeding, stopping the medicine can
sometimes help raise the platelet count or prevent bleeding. For example,
aspirin and ibuprofen are common medicines that reduce platelet function and
increase the chance of bleeding. If you have ITP, you shouldnt use these
medicines.
|