An initial course of prednisone (a corticosteroid) is often given to newly diagnosed patients. Prednisone suppresses the immune system. It is hoped that suppressing the immune system will cause the patient’s platelet count to increase and remain elevated after the patient stops taking prednisone. Sometimes a short course of dexamethasone, another corticosteroid, is used instead of prednisone.
There are 5 main treatments for ITP (of course there are others but these are the 5 main go-tos):
- IVIG: a liquid concentrate of antibodies purified from the plasma (the liquid portion of the blood that doesn’t contain red blood cells) of healthy blood donors.
- WinRho: is also a liquid concentrate of antibodies derived from healthy human plasma. However, this medicine is targeted against the Rh factor* on red blood cells. It is thought that WinRho binds to red blood cells to such an extent that the spleen is fully occupied eliminating red blood cells and does not have much opportunity to remove the antibody-coated platelets.
- Chemotherapy Agents (Rituxan): reduces the number of B cells in the body. B cells are a type of white blood cell that, when activated, multiply and produce antibodies. Since Rituxan reduces the number of B cells, it also reduces the number of cells that produce antibodies, including the antibodies that attack platelets, thereby enabling the platelet count to rise.
- Spleen Removal: The spleen is a large blood filter which, for many people, removes antibody-coated platelets. Theoretically, if the spleen is removed, the platelets will remain in circulation. However, there are other ways the body removes platelets, so this treatment sometimes fails to have a lasting effect.
Some of the side effects of these are:
Steroids: patients may become more irritable, have stomach upsets, sleep disturbances, increased appetite, weight gain, puffy cheeks, frequent urination, sugar in the urine, loss of bone density, or acne. When the medicine is stopped, most side effects will begin to disappear.
IVIG: Some patients treated with IVIg experience nausea and vomiting, headaches or fever and rarely, aseptic meningitis, abnormal blood clots or kidney failure. Many patients are helped by pretreatment with acetaminophen and Benadryl
WinRho: Temporary side effects include fever, headache, chills, nausea and vomiting, anemia, and rarely, kidney failure. Rare cases of intravascular hemolysis (red cell destruction) has been experienced by a small number of patients.
Rituxan: Side effects of Rituxan were reported in 87% of patients. Ten percent of patients reported very serious adverse effects that included fever, chills, weakness, nausea and headaches. Some hypersensitive patients may get serum sickness. Some rare cases of progressive multifocal leukoencephalophathy due to a specific virus have been reported to the FDA.
Spleen Removal: Short-term complications of splenectomy immediately following surgery may include infection, incisional bleeding, deep vein blood clots, pneumonia, incisional hernia, pancreas inflammation, and pulmonary embolism (blood clot that travels to the lungs). While general anesthesia prevents pain during the surgery, there may be incisional pain for several days after surgery. The spleen filters your blood and produces antibodies to help fight infections.
This was taken directly from PDSA