Treatment for ITP is recommended for a platelet count less than 30x109/L. Corticosteroids are considered first-line treatment, with the addition of IVIG reserved for severe ITP and bleeding, when a rapid rise in platelets is required, or when corticosteroids are contraindicated. There is no evidence of benefit of IVIG in combination with corticosteroids for first-line treatment of asymptomatic ITP. Unnecessary IVIG infusions can result in multiple adverse effects, including acute hemolytic or anaphylactic reactions, infections, thromboembolic events, and aseptic meningitis.

Conditions: Immune Thrombocytopenia (ITP), Low Platelet Count

Treatments: Intravenous Immunoglobulin (IVIG), Corticosteroids

Sources

• Health Quality Ontario. Intravenous immune globulin for primary immune thrombocytopenia: a rapid review. 2014 [cited 2014 Aug 21]. (HQOntario)
• Neunert C, Lim W, Crowther M, Cohen A, Solberg L, Jr., Crowther MA. The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia. Blood. Apr 21 2011;117(16):4190-4207. (PubMed)
• Neunert CE. Current management of immune thrombocytopenia. Hematology Am. Soc. Hematol. Educ. Program. 2013;2013:276-282. (PubMed)
• Provan D, Stasi R, Newland AC, et al. International consensus report on the investigation and management of primary immune thrombocytopenia. Blood. Jan 14 2010;115(2):168-186. (PubMed)