Should I start Eltrombopag for ITP at age 30?

Question

Hello doctor,

I am 30 and was diagnosed with ITP a year ago. My platelet count usually hovers between 30,000 and 40,000 per microlitre, but recently dropped to 18,000 after a viral infection. I have been on steroids before, but they caused weight gain and mood swings. I am now being considered for Eltrombopag. Please let me know the following:

How does that work, and is it safe in the long term?
Will I ever go into remission?
I am scared of bleeding risks. Can I travel or play light sports?
Also, should I avoid certain foods or medications, such as Aspirin?
Can you explain in simple words how my immune system is affecting platelets and what options I have?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

I understand how living with ITP (immune thrombocytopenia, an illness that can lead to bruising and bleeding) can be stressful, especially when your platelet counts fluctuate, and you are worried about bleeding.

In simple terms, your immune system is mistakenly attacking and destroying your platelets, cells that help your blood clot, thinking they are foreign. That is why your count is low, and it can drop further due to factors like infections.

Eltrombopag is a thrombopoietin receptor agonist; it works by stimulating your bone marrow to produce more platelets to counteract the destruction. It is generally well tolerated for long-term use, but we monitor liver function and iron levels regularly. Many patients do achieve remission over time, especially if their ITP started after a trigger like an infection.

With platelets around 18,000 platelets per microlitre, there is a higher risk of bleeding, so it is smart to avoid medications like Aspirin, Ibuprofen, and anything that thins the blood unless your doctor specifically allows it.

As for lifestyle, once your count is safely above 30 to 50k, light sports, travel, and regular activities are usually okay, though you should avoid contact sports or anything with high bleeding risk unless your count is well controlled.

A healthy diet is good, but there are no specific foods that worsen ITP; just avoid supplements or herbs that might thin the blood. Stay closely monitored, and if Eltrombopag works well, it can give you reasonable control with fewer side effects than steroids.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.