What are the benefits of IV Rho immunoglobulin (RhIG) in the treatment of immune thrombocytopenic purpura (ITP) in children?

Updated: Apr 22, 2018
  • Author: Craig M Kessler, MD, MACP; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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Answer

An advantage of IV RhIG is that if bone marrow aspiration is unacceptable to parents and if the diagnosis of acute ITP is equivocal, IV RhIG is an effective treatment that avoids the problem of a misdiagnosis of acute leukemia because of steroid-related changes in the marrow.

For children or adolescents with ITP who have significant ongoing bleeding despite treatment with IVIG, RhIG, or conventional doses of corticosteroids, the ASH recommends considering rituximab or high-dose dexamethasone for second-line treatment. Rituximab or high-dose dexamethasone may also be considered as an alternative to splenectomy or as treatment for children and adolescents who do not respond favorably to splenectomy. [8]


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