Immune Thrombocytopenia (ITP) | Diagnosis & Treatment

How is immune thrombocytopenia diagnosed?

The first step in treating your child is forming an accurate and complete diagnosis. ITP can usually be identified by:

  • a careful medical history
  • physical examination
  • complete blood count (CBC), including a hematologist’s examination of the blood under the microscope

After all tests are completed, doctors will be able to outline the best treatment options.

What are the treatment options for ITP

There are a number of treatments that can help increase platelet levels in children with immune thrombocytopenia (ITP), but there is no cure. The majority of children with ITP get better gradually on their own in a few days, weeks or sometimes months, with or without treatment.

When treatment is necessary, the most common forms are:

  • steroids (usually prednisone) to temporarily reduce production of antibodies and increase platelet count by slowing the rate at which the spleen destroys them
  • intravenous gamma globulin (also known as intravenous immunoglobulin, or IVIG), a human blood product containing antibodies that help slow the rate at which abnormal platelets are destroyed by the spleen
  • intravenous Rho (D) immune globulin (also known as WinRho®), a human plasma product that temporarily stops the spleen from destroying platelets; children must be blood type Rh positive and still have their spleen to receive this treatment

Steroids

  • temporarily reduce production of abnormal antibodies and increase platelet count by slowing the rate at which platelets are destroyed by the spleen
  • may be taken orally
  • side effects may include irritability, stomach irritation, weight gain, high blood pressure, acne or elevated levels of sugar in the urine

Intravenous gamma globulin (also known as intravenous immunoglobulin, or IVIG)

  • a human blood product containing many antibodies that help slow the rate at which abnormal platelets are destroyed by the spleen
  • given over three to six hours through a needle inserted into a vein
  • temporary side effects include fever, chills, headache, muscle and joint pain, hives, rash or allergic reactions

Intravenous Rho (D) immune globulin (also known as WinRho®)

  • temporarily stops the spleen from destroying platelets
  • child must have Rh-positive blood and must still have their spleen in order for this medication to be effective
  • given intravenously
  • temporary side effects include: mild anemia, fever, chills, headache, blood pressure changes or allergic reactions
  • rarely, severe anemia from breakdown of blood cells can occur; this can possibly result in kidney damage

Other treatments for ITP

  • surgery to remove spleen (splenectomy) – considered more often in older children with chronic ITP
  • 6-mercaptopurine (also called Purinethol or 6-MP) – causes mild immune suppression, which helps to reduce platelet destruction.
  • hormone therapy – for teenage girls, to stop their menstrual cycle if excessive bleeding occurs

Children with ITP also may receive antibiotics to treat infections.

What is the long-term outlook for children with ITP?

More than 80 percent of children with treated ITP recover on their own in days, weeks or months. Fatal brain hemorrhages rarely occur with steroid, intravenous Rh immune globulin or intravenous gamma globulin therapy.

Recurrence of ITP is uncommon, but it can occur up to several years after the initial episode and may be associated with another viral infection.

The sports and activities your child can participate in will depend on their platelet count (the severity of the ITP). Your child’s physician can make specific recommendations on the types of activities that may be appropriate, depending on their platelet levels. (Learn more about ITP and sports on our ITP Kids website.)