Does anyone knows the right treatment of ITP?

Question

My son is only 5 years old and he is diagnosted ITP last year since then, he is addmitted in hospital more than 4 times. His platelets go down as low as 8000. Doctors gave him alot of different medicine but each time he treated his platelets jump to around 80,000 or sometime cross 100,000 but within a month or two it comes down. we are riding in a roller coaster since then. We are giving him chiness herbs too since last 6 months but nothing is working.

Answer 1

Mild ITP does not require treatment. When platelet counts fall under 10,000 per microliter, or under 50,000 when hemorrhage occurs (e.g. in the digestive tract or in a severe nosebleed) treatment is generally initiated with steroids. Intravenous immunoglobulin (IVIg) is used for life threatening cases. Later, so-called steroid-sparing agents (alternatively called DMARDs) may be used. When these strategies fail, splenectomy (removal of the spleen) is often undertaken, as platelets targeted for destruction will often meet their fate in the spleen. A relatively new strategy is treatment with anti-D, an agent used in mothers who have been sensitized to rhesus antigen by a Rh+ baby, but the patient must be Rh+. Immunosuppresants like mycophenolate mofetil and azathioprine are becoming more popular for their effectiveness. Rituximab has also been used with some success for some patients.

Extreme cases (very rare, especially rare in children) may require vincristine, a chemotherapy agent, to stop the immune system from destroying platelets.

Intravenous immunoglobulin, while sometimes effective although not all patients respond, is expensive and the improvement is temporary (generally lasting less than a month). However, in the case of a pre-splenectomy ITP patient with dangerously low platelet counts, and a poor response to other treatments, IVIg treatment can increase platelet counts, making the splenectomy operation less dangerous.

Platelet transfusion is not normally recommended and is usually unsuccessful in raising a patient's platelet count. This is because the underlying autoimmune mechanism that destroyed the patient's platelets to begin with will also destroy donor platelets. An exception to this rule is when a patient is bleeding profusely, when transfusion of platelets can quickly form a platelet plug to stop bleeding.

AMG 531 is an experimental treatment for stimulating platelet production. Initial clinical trials show it to be moderately effective in chronic ITP, but its role in the treatment of ITP is still unknown, given that existing treatments are generally effective and that the underlying problem in ITP is the increased destruction of platelets, not their production.

http://en.wikipedia.org/wiki/Idiopathic_thrombocytopenic_purpura#Treatment

Answer 2

Not all people respond the same way to ITP, and worse yet, many doctors are not well-versed in treating the disorder. The usual first line medication is prednisone (at least in adults), but maybe this is not a good medication for kids. There are quite a few approaches to treating ITP and finding the right treatment often requires trial and error. There are a number of dietary things that can trigger low platelet counts. Some antibiotics can also cause ITP.

When I was first diagnosed with ITP, I had a platelet count of 0. At one time I would have tried nearly anything to have had a count as high as 8,000. I learned not to pay attention to the blood counts, but instead mange things based on my symptoms. I really didn't have many problems with counts between 8,000 - 10,000, although the consensus for a minimum "safe" level is around 20,000. I did not seek treatment if my counts were 8,000 or above. My ITP eventually went away after long-term use of prednisone.

There is an ITP support site with really good information:

http://www.itppeople.com/

Answer 3

usually the children with ITP will require no treatment and resolve spontaneously but some patients require treatment with Intra venous immunoglobulins(IVIG)/or corticosteroid
i wish your son will be ok in no time ..take care