Terry Gernsheimer, MD, and Michele B. Frank, MD

Dr. Gernsheimer: Puget Sound Blood Center and University of Washington School of Medicine, Seattle, WA
Dr. Frank: Cascade Cancer Center, Kirkland, WA

Copyright of the American Society of Hematology, 2006. ISSN: 1931-6860.

This case was reviewed and updated in January 2011 by Dr. Alvin H. Schmaier and members of the Teaching Cases Subcommittee.


You order liver function tests to screen for hepatitis or other liver disease, and an HIV screen. The results will be available in two weeks.

What are the best treatment options for this patient, who presents with acute ITP? (Choose all that apply.)
NOTE: This patient is 23 years old, and therefore falls into the category of adult ITP. Childhood ITP remits spontaneously 90% of the time, so treatment should be limited only to children with severe bleeding symptoms. What are the first immediate treatment options for this patient?

Platelet transfusion
Intravenous immune globulin (IV IgG) and prednisone
Anti-RhD immunoglobulin (WinRho®) and prednisone

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