Idiopathic Thrombocytopenic Purpura

Treatment

Sometimes ITP requires no treatment, only careful observation. At other times urgent intervention is needed. Treatment for ITP depends on the severity of the patient's condition. It also depends on whether the patient is being treated for the first time or for a recurring case of ITP. Treatment for ITP may include several types of medications and occasionally surgery to remove the spleen.

Medications

Hematologists at Mayo Clinic may administer immunoglobulin (specially formulated antibody) intravenously to try to get a rapid increase in the platelet count. This is usually done when the platelet count is dangerously low. Depending upon the patient's condition, immunoglobulin may be administered one time or daily for several days. It usually works quickly to prevent the spleen from destroying platelets, but usually does not have a long-term effect on ITP.

Immunosuppressive drugs such as steroids may also be used to treat ITP. Immunosuppressive drugs decrease the body's production of the antibody that attaches itself to platelets and leads to their destruction. Hematologists carefully watch platelet counts during treatment. Occasionally chemotherapy may be administered to treat ITP cases that do not respond to other medications or surgery to remove the spleen.

Surgery

Occasionally the spleen may need to be removed in an operation called a splenectomy. This is most commonly done for patients who have a low platelet count despite taking immunosuppressive drugs. Skilled surgeons at Mayo Clinic offer both traditional and minimally invasive techniques (laparascopic surgery) to remove the spleen. Laparascopic splenectomies typically require a hospital stay that averages two days, versus five days for open surgery.

After Treatment

No matter what treatment is chosen, occasionally ITP recurs. Patients should watch carefully for symptoms. Mayo Clinic physicians work with each patient to minimize effects of treatment and to watch for recurrences.