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Patient handout

Immune Thrombocytopenia (ITP) — initial diagnosis & acute Rx

PRODUCTION

1. Your condition

This handout is for immune thrombocytopenia (itp) — initial diagnosis & acute rx. Your care team identified this based on: isolated thrombocytopenia (platelet count <100k) with otherwise normal cbc — ash 2019 neunert.

Other reasons your team may use this plan: petechiae / purpura / mucocutaneous bleeding — ash 2019 neunert; major bleeding (intracranial/gi) — emergency presentation — ash 2019 neunert; bsh 2024.

2. Your medications

Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.

MedicationStarting doseHowWhenWhat it does
dexamethasoneASH 2019; FLIGHT — 40 mg ×4d preferred over prednisone
prednisoneASH 2019 — 1 mg/kg/d ×2–3w taper
ivigASH 2019 — 1 g/kg/d ×1–2d when rapid Rx required

Plan: ITP first-line (acute)

3. When to call your provider

Contact your care team if any of the following happen:

  • Recurrent bleed → restart inpatient bundle — ASH 2019 Neunert
  • Persistent >12 months → chronic engine — ASH 2019 Neunert; Provan Blood Adv 2019

4. When to seek emergency care

Call 911 or go to the nearest emergency room right away if you have:

  • ICH / GI bleed / pulm hemorrhage with plt <30k — ASH 2019 Neunert(life-threatening)
  • Plt <10k regardless of bleeding — ASH 2019 Neunert; Provan Blood Adv 2019
  • Plt drop on heparin + 4Ts ≥4 — ASH 2019 Neunert; Warkentin 2003
  • ITP + autoimmune hemolytic anemia (positive DAT + low Hb + retics up) — ASH 2019 Neunert; Provan Blood Adv 2019

5. Follow-up

Hem clinic follow-up; vaccination plan if rituximab/splenectomy planned; transition to chronic engine if persistent >12 months — ASH 2019 Neunert; BSH 2024

6. Sources

Guideline: ASH 2019 ITP Guidelines (Neunert Blood Advances) + 2025 ASH Draft Update + International Consensus Report 2019

  1. pubmed.ncbi.nlm.nih.gov/31794604
  2. pubmed.ncbi.nlm.nih.gov/18242413
  3. pubmed.ncbi.nlm.nih.gov/23361904