Emergency Treatment of Chronic ITP
**Please note! The drug doses that are described here represent those commonly prescribed. However, drug doses in individual patients may differ from those listed here and depend on the patient's clinical situation and the prescribing doctor's preferences. Decisions on the treatment of individual patients with ITP are the sole responsibility of the treating physician.
Occasionally, patients with chronic ITP will have severe and potentially life-threatening bleeding. Patients with severe bleeding, due to very low platelet counts (usually less than 5,000), are given one of the following treatments. The results with each treatment are similar. Most patients respond within several hours by increasing their platelet count to safe levels.
- Intravenous gammaglobulin. Usually 50 to 100 grams is given intravenously daily for 1-3 days.
- High-dose corticosteroids. Usually 1 gram of methylprednisolone is given intravenously daily for 3 days. An equivalent dose of another corticosteroid may also be used.
- Both therapies. Rarely, in extreme circumstances, both intravenous gammaglobulin and high-dose corticosteroids are given.
In addition to one of the above treatments, platelet transfusions are given as often as necessary until bleeding has stopped.
Note. One study reported that anti-D therapy, given at a higher dose than usual (75 ug/kg/d), may also be useful under emergency circumstances.
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