Rx of ITP - chinni17

[ArchivalUser]

what is the sequence of treatment for ITP,
wich is first,IV ig or Prednisolone?

[ArchivalUser]

most adults respond to steroids within 2 weeks.

when pt fails to respond to steroids , splenectomy is indicated.

when a pt fails to respond to steroids and splenectomy he is treated with danazol or cytotoxic agents like cyclophosphamide.

IVIG - indicated when there is bleeding emergency or when platelet counts are to be raised in a severe thrombocytopenic pt before surgery.

[ArchivalUser]

is there any difference in kids,because in pediatrics kaplan,it is given as immunoglobulins first???

[ArchivalUser]

children.-ITP
-platelet count 30,000-NO TREATMENT.

[ArchivalUser]

if platelet count is less than 30,000-corticosteroids are given in kids (UW)
IF more than 30,000-no treatment.

[ArchivalUser]

thank you kiranraja...

[ArchivalUser]

>30,000 platelets just observation

[ArchivalUser]

sorry my posting did not come
less than 30000 platelets give steroids

If platelets 10000 to 20000 after steroids then do splenectomy

If platelet count is less than 10000 try IvIG or Rhogam (especially rh positive patients.. Not rh negative patients...)
Its the same Rhogam given in rh nagative pregnat patients but here in rh positive patients

In refractory cases you can try rituximab anti CD20 antibody

[ArchivalUser]

Prednisone. first. if no response, or patient is bleeding, add IVIg.

If replase or refractory to above therapy, spenectomy or immunosuppresive agents.

Try WinRho in Rh-positive patient If poor surgery candidate or unwilling to remove spleen.

for life threatening (severe bleeding), give steroid, IVIg and platelet transfusion.

for preop preparation, give IVIg.