Treatment for immune thrombocytopenia (ITP) is based on how much and how often you're bleeding and your platelet count.
Adults who have mild ITP may not need any treatment, other than watching their symptoms and platelet counts. Adults who have ITP with very low platelet counts or bleeding problems often are treated.
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), usually are treated.
Children who have mild ITP may not need treatment other than monitoring and followup to make sure their platelet counts return to normal.
Medicines often are used as the first course of treatment for both children and adults.
Corticosteroids (cor-ti-co-STEER-roids), such as prednisone, are commonly used to treat ITP. These medicines, called steroids for short, help increase your platelet count. However, steroids have many side effects. Some people relapse (get worse) when treatment ends.
The steroids used to treat ITP are different from the illegal steroids that some athletes take to enhance performance. Corticosteroids aren't habit-forming, even if you take them for many years.
Other medicines also are used to raise the platelet count. Some are given through a needle inserted into a vein. These medicines include rituximab, immune globulin, and anti-Rh (D) immunoglobulin.
Medicines also may be used with a procedure to remove the spleen called splenectomy (splee-NECK-tuh-mee).
If medicines or splenectomy don't help, two newer medicines—eltrombopag and romiplostim—can be used to treat ITP.
Removal of the Spleen (Splenectomy)
If needed, doctors can surgically remove the spleen. This organ is located in the upper left abdomen. The spleen is about the size of a golf ball in children and a baseball in adults.
The spleen makes antibodies (proteins) that help fight infections. In ITP, these antibodies destroy platelets by mistake.
If ITP hasn't responded to medicines, removing the spleen will reduce the destruction of platelets. However, it also may raise your risk for infections. Before you have the surgery, your doctor may give you vaccines to help prevent infections.
If your spleen is removed, your doctor will explain what steps you can take to help avoid infections and what symptoms to watch for.
Some people who have ITP with severe bleeding may need to have platelet transfusions and be hospitalized. Some people will need platelet transfusions before having surgery.
For a platelet transfusion, donor platelets from a blood bank are injected into the recipient's bloodstream. This increases the platelet count for a short time.
For more information about platelet transfusions, go to the Health Topics Blood Transfusion article.
Some infections can briefly lower your platelet count. Treating the infection may help increase your platelet count and reduce bleeding problems.
Some medicines can lower your platelet count or cause bleeding. Stopping the medicine can sometimes help raise your platelet count or prevent bleeding.
For example, aspirin and ibuprofen are common medicines that increase the risk of bleeding. If you have ITP, your doctor may suggest that you avoid these medicines.