What is included in emergency department (ED) care for immune thrombocytopenia (ITP)?

Updated: Dec 14, 2019
  • Author: Michael A Silverman, MD, MD; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
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Answer

The patient with known ITP who has bleeding that poses a threat to life, limb, or sight requires treatment to improve hemostasis along with conventional critical care interventions. Intravenous immunoglobulin (IVIG), which has the most rapid onset of action, should be considered along with high-dose parenteral glucocorticoids. In patients who require a more rapid rise in their platelet count, case reports suggest that the following treatments may be useful [5] :

  • Platelet transfusions, possibly in conjunction with a continuous infusion of IVIG
  • Recombinant factor VIIa (however, note the risk of thrombosis)
  • Antifibrinolytic agents (aminocaproic acid, tranexamic acid) 

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