Treatments for Immune Thrombocytopenic Purpura
Treatments for Immune Thrombocytopenic Purpura
The list of treatments mentioned in various sources
for Immune Thrombocytopenic Purpura
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
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Discussion of treatments for Immune Thrombocytopenic Purpura:
If the doctor thinks a drug is the cause of the
thrombocytopenia, standard treatment involves discontinuing the drug's
use. Infection, if present, is treated vigorously since control of the
infection may result in a return of the platelet count to normal.
The treatment of idiopathic thrombocytopenic purpura is determined by
the severity of the symptoms. In some cases, no therapy is needed. In most
cases, drugs that alter the immune system's attack on the platelet are
prescribed. These include corticosteroids (i.e., prednisone) and/or
intravenous infusions of immune globulin. Another treatment that usually
results in an increased number of platelet is removal of the spleen, the
organ that destroys antibody-coated platelet. Other drugs such as
vincristine, azathioprine (Imuran), Danazol, cyclophosphamide, and
cyclosporine are prescribed for patients only in the severe case where
other treatments have not shown benefit since these drugs have potentially
harmful side effects.
Except in certain situations, (e.g., internal bleeding and preparation
for surgery), platelet transfusions usually are not beneficial and,
therefore, are seldom performed. Because all therapies can have risks, it
is important that overtreatment (treatment based solely on platelet counts
and not on symptoms) be avoided. In some instances lifestyle adjustments
may be helpful for prevention of bleeding due to injury. These would
include use of protective gear such as helmets and avoidance of contact
sports in symptomatic patients or when platelet counts are less than
50,000. Otherwise, patients usually can carry on normal activities, but
final decisions about activity should be made in consultation with the
patient's hematologist.
(Source: excerpt from Immune Thrombocytopenic Purpura (ITP): NIDDK)
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Book Excerpts: Treatment of Immune Thrombocytopenic Purpura
Treatments of Immune Thrombocytopenic Purpura: Online Medical Books
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Purpura:
Treatment
(In a Page: Signs and Symptoms)
-
Discontinue causative medications
-
Correct coagulopathies as necessary
-
Treat malignancy as necessary
-
Sun protection and avoidance of trauma will prevent actinic and age-related purpura
-
Treat stasis-associated lower extremity purpura with compression stockings, elevation, and diuretics if edema is present
-
Infections: Prompt antimicrobial treatment (e.g., doxycycline for RMSF, ceftriaxone for meningococcemia) is imperative to prevent mortality
-
Autoimmune diseases: High-dose corticosteroids followed by steroid-sparing medications (e.g., methotrexate, cyclosporine, azathioprine, mycophenolate mofetil) for long-term treatment
-
Idiopathic pigmented purpuras are most common on the lower legs of men, and may resolve spontaneously or persist indefinitely; high potency topical steroids and oral vitamin C sometimes hasten their resolution
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Purpura:
Treatment
(In A Page: Pediatric Signs and Symptoms)
- HSP: Analgesia, hydration, treat complications
–Corticosteroid use is controversial
- ITP with platelet count <20,000
–IV immunoglobulin to block macrophage receptors
–Anti-Rh immunoglobulin binds to RBCs so the spleen destroys RBCs instead of platelets, corticosteroids
–Treat to raise platelet count and decrease risk of
intracranial hemorrhage
–Emergency: Platelet transfusion
–Chronic: Immunosuppressant or splenectomy
-
Hemophilia A: Recombinant F VIII
–IV or intranasal DDAVP (desmopressin) releases F VIII and vWF from endothelial cells
-
Hemophilia B: Recombinant or plasma-derived F IX
-
DIC: Treat cause; transfuse platelets, cryoprecipitate, or fresh frozen plasma
- vWD: DDAVP or plasma-derived vWF
-
PAN: Oral or IV corticosteroid
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Source: In A Page: Pediatric Signs and Symptoms, 2007
Thrombocytopenia:
Treatment
(In A Page: Pediatric Signs and Symptoms)
- Dependent upon etiology, severity, and presence of acute bleeding
- ITP
–Bone marrow exam before treatment with steroids
–Treatment with IVIG or WinRho does not need bone marrow exam
–Platelet transfusion is ineffective in ITP but should be considered at counts <20,000 in the neonate or with life-threatening hemorrhage
–Severe injury is unlikely if count >10,000
–Treatment does not hasten resolution of ITP
–About 90% of children have resolution in 3–6 months
–Older girls more likely to become chronic
- Acute, isolated thrombocytopenia is almost never malignancy
–Marrow exam should be done in children with chronic or complex illness or with no response to therapy
