When is splenectomy indicated in the treatment of 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

Splenectomy is reserved for patients in whom medical therapy fails. Fortunately, thrombopoietin receptor agonists can often provide effective second-line management of patients with persistently low platelet counts and bleeding, thus averting surgery. [6]  When medical therapy fails in a patient with life-threatening bleeding, emergent splenectomy (with or without IVIG and/or corticosteroids and usually with platelet transfusions) may be considered as a heroic measure. [5]


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