Which medications are recommended for the treatment of chronic immune thrombocytopenic purpura (ITP) platelet disorder?

Updated: Aug 05, 2017
  • Author: Perumal Thiagarajan, MD; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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Although a number of agents (eg, dapsone) have been studied for treatment of pediatric patients with chronic ITP that is refractory to conventional agents, the American Society of Hematology found insufficient evidence to support recommendations regarding their use (with the possible exception of dapsone). American Society of Hematology guidelines recommend consideration of the following for treatment of refractory chronic ITP in children and adolescents [1] :

  • Rituximab or high-dose dexamethasone, for patients with significant ongoing bleeding despite treatment with IVIG, anti-D, or conventional doses of corticosteroids

  • Rituximab or high-dose dexamethasone as an alternative to splenectomy or in patients who do not respond favorably to splenectomy

Children with chronic ITP who are scheduled for splenectomy should receive pneumococcal and Haemophilus influenzae vaccines before the operation. Many physicians recommend that patients receive a prophylactic antibiotic regimen after splenectomy.

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