title: Classical management of refractory adult immune (idiopathic) thrombocytopenic purpura.
abstract: Treatment of chronic immune (idiopathic) thrombocytopenic purpura with corticosteroids and/or splenectomy results in safe platelet counts in over 70% of patients without additional treatment. Therapy of patients who are refractory to these two treatments may be difficult. The treatment approach to refractory ITP patients, described in this report, is arbitrarily divided into four levels: levels 1 through 3 represent treatments with increasing side effects; level 4 therapy may be tried when the others have failed. Patients undergoing these treatments may require concomitant intravenous gammaglobulin, high-dose corticosteroids or platelets, to maintain the platelet count in the setting of mucosal bleeding or severe thrombocytopenia.
authors.affiliation: The Scripps Research Institute, La Jolla, CA 92037, USA. mcmillan@scripps.edu
authors.forename: R
authors.initials: R
authors.lastname: McMillan
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002908:Chronic Disease; D019468:Disease Management; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000188:drug therapy*; D018570:Risk Assessment; D016879:Salvage Therapy
chemical_list: D000970:Antineoplastic Agents; D007166:Immunosuppressive Agents