Patient's Query
Hello doctor,
Last year, my 26-year-old sister was diagnosed with chronic immune thrombocytopenic purpura (ITP) after several incidences of bruising and gum bleeding. Initially, she was on steroids; however, she still experiences irregular platelet levels.
The doctors have proposed that they use Rituximab, but we are afraid of any adverse long-term effects. We would like to know how chronic ITP is managed in young ladies and if using any drugs such as Rituximab may pose any risks of infection or infertility.What other long-term management is better in case steroids do not stabilize the condition?
Please help.
Hello,
Welcome to icliniq.com.
I have read your query and understand your concern.
The treatment of chronic immune thrombocytopenic purpura (ITP) mainly depends on the degree of symptoms, platelet count, bleeding tendency, and the effectiveness of past treatments.
Some individuals with relatively low platelet counts and mild symptoms may only require monitoring without treatment at once.
Steroid treatment is mostly used and can effectively increase platelet count for some time.
But in cases where there is persistent fluctuation in platelet count and recurrence of symptoms, other treatment options like Rituximab, IVIG, or thrombopoietin receptor agonists such as Eltrombopag may be utilized.
The mode of action of Rituximab entails suppression of the immune cells causing platelets' destruction. Overall, it is safe, yet, due to its impact on the immune system, patients may experience higher susceptibility to infections.
Regular blood count check and control are essential during treatment.
Fertility issues are uncommon with this medication, many young women receive such treatment without any complications. However, it is still vital to discuss future fertility plans with your hematologist prior to the initiation of treatment.
There is also another available treatment, Eltrombopag, which has been found to be very effective among chronic ITP patients and can ensure sustained platelet counts. The choice of the optimal treatment strategy depends on patient's symptoms of bleeding, platelet count, general state of health and response to previous treatment.
I hope this helps. Thank you.
I hope this helps.
Thank you.
Same symptoms don't mean you have the same problem. Consult a doctor now!
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