What are the International Consensus Report recommendations for treatment of life threatening bleeding in adults with immune thrombocytopenia (ITP)?

Updated: Jan 11, 2020
  • Author: Craig M Kessler, MD, MACP; Chief Editor: Srikanth Nagalla, MBBS, MS, FACP  more...
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Answer

Treatment of life-threatening bleeding:

  • In emergency situations in which there is an urgent need to increase the platelet count within 24 hours, a combination of initial treatments, including IV corticosteroids and, usually, IVIG, should be used. Platelet transfusions may be helpful and must not be postponed in cases of life-threatening bleeding, especially intracranial hemorrhage (ICH).
  • In the case of life-threatening bleeding and the absence of a significant response to IVIG and platelet transfusion in a patient on corticosteroids, consider use of a TPO-RA.
  • Additional options may include IV anti-D; vincristine or vinblastine; antifibrinolytics in combination with other initial therapies; and, rarely, emergency splenectomy.

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