ITP Mx - amith

[ArchivalUser]

Trt is Observation (MC in children)---------> Trt with corticosteroids needed if platelet <30.000 and/or symptoms r severe or if recurrent and no recovery-------->if life threatening spleenectomy may be live saving.

[ArchivalUser]

Every attempt should be made to control patient on steroids and other immunosuppresive drugs before embarking on splenectomy. If after adequate trial of conservative measures fails, only then splenectomy should be done. Even patients with plt count of as low as five thousand per cubic millimeter will respond to steroids or IVIg. Children usually have acute self limiting ITP and thus only monitoring is required , unless they have life threatening bleed, they should not be started on therapy immediately.

Another important thing is to consider immunisation against capsulated organisms in patients who are to b taken up for splenectomy or even after splenectomy.

Postsplenectomy sepsis is a fulminant sepsis that can be life threatening within a matter of hours, thus all fevers in splenectomised patients should be treated as emergency and empirical antibiotic in form of peniciilin may be started till culture results are available. These patients are also at high risk to develop severe malaria or babesiosis.

Sometimes accessory spleen grow up leading to recurrence of ITP after splenectomy and these need to be picked up by radionucleotide scan and removed.

[ArchivalUser]

ajeet thx very much cud yu pls post the same in uw thread under title itp....