Is Rituximab safe for women with ITP?

Question

Hello doctor,

I am 31 years old, diagnosed with ITP last year after my platelet count dropped to 22,000. I had gum bleeding and bruises on my legs. Steroids helped, but once I stopped, counts went low again. Now the doctor is talking about Rituximab or thrombopoietin receptor agonists. I am worried about long‑term side effects. Also, is pregnancy risky with ITP? My mother had anemia issues, but not low platelets. Can lifestyle or diet improve platelet count, or only medicines?

Kindly help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

In immune thrombocytopenia (ITP), when steroids do not provide lasting remission, the next options often include Rituximab (which targets the immune cells producing antibodies against platelets) or thrombopoietin receptor agonists (like Eltrombopag or Romiplostim, which stimulate platelet production).

Both can be effective, but each has potential long‑term considerations. Rituximab may increase the risk of infections for months after treatment due to reduced immunity, while thrombopoietin receptor agonists are usually safe with monitoring but require ongoing use in many patients.

Pregnancy with ITP can be managed safely in most cases, though close monitoring is needed since platelet counts may fluctuate, and treatment decisions are individualized to protect both mother and baby.

Family history of anemia does not necessarily increase your risk of ITP, as it is typically autoimmune rather than inherited. Unfortunately, lifestyle or dietary changes alone cannot correct the low platelet count in ITP. Maintaining good nutrition and avoiding alcohol or unnecessary medications that affect platelets (like NSAIDs - non-steroidal anti-inflammatory drugs) is wise.

The mainstay of improving platelet counts remains medical therapy, and your hematologist will tailor treatment based on your response and risks.

I hope that this answers your query.

Kindly follow up if you have more doubts.

Thank you.