Chronic refractory Idiopathic Thrombocytopenic Purpura (ITP)-management options.pdf

1、Idiopathic thrombocytopenic purpura (ITP) is the most common bleeding disorder in the pediatric population.It is an autoimmune condition characterised by a low platelet count mediated by platelet-antibody destruction by

2、the reticuloendothelial system.While most of the children recover completely within 6 months,around 10-20％ follows a chronic course.Few of them will be refractory to the common treatment strategies,namely glucocorticoids

3、, intravenous immunoglobulin(IVIG)，anti-D，and splenectomy. These children warrant second line treatment with other drugs. However there is currently no consensus on how best to treat patients who are refractory to treatm

4、ent. This is primarily because of the need for individualised treatment due to the wide variation between patients in terms of their unique needs and preferences,underlying pathophysiology, bleeding propensity,platelet r

5、esponses to specific therapies,toxicities of treatments.Many studies have reported results of different therapeutic approaches.A number of drugs have been tried,alone or in combination,with various outcomes.The aim of th