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What treatment options are available for a child with chronic ITP who isn't responding to treatment and has a very low platelet count of 4,000?

A platelet count of 4,000 is dangerously low and requires immediate medical attention. At this level, there's a serious risk of severe bleeding, including potentially Show Full Answer

What treatment options are available for a child with chronic ITP who isn't responding to treatment and has a very low platelet count of 4,000?

A platelet count of 4,000 is dangerously low and requires immediate medical attention. At this level, there's a serious risk of severe bleeding, including potentially life-threatening internal bleeding.

When initial treatments aren't working, doctors typically move to second-line and third-line options. These include:

- Rituximab (Rituxan) - blocks immune cells from making the antibodies that destroy platelets
- Thrombopoietin receptor agonists - medications like eltrombopag (Promacta) and romiplostim (Nplate) that trigger the bone marrow to produce more platelets
- Immunosuppressants - medications like azathioprine that reduce immune system activity
- Splenectomy - surgical removal of the spleen, though this is typically reserved for severe cases

For extremely low platelet counts, emergency treatments like IVIG or high-dose corticosteroids may be used to quickly raise levels, even if previous responses weren't sustained.

It's critical to work closely with a pediatric hematologist who specializes in ITP. They can evaluate why current treatments aren't working and adjust the approach accordingly. During this time, preventing injuries and avoiding activities that could cause bleeding is essential.

 AI-generated responses are not a substitute for medical advice. These services are not intended to diagnose, treat, or cure any condition or disease. Always ask your doctor about specific health concerns.

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