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Immune thrombocytopenia with bleeding — RCPSC IM MCQ

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ModerateHematologyImmune thrombocytopenia with bleedingRCPSC IM

A 26-year-old woman has mucosal bleeding and petechiae. Platelets are 6 x 10^9/L, hemoglobin is normal and blood film shows large platelets without blasts or schistocytes. Pregnancy test is negative and HIV/HCV testing has been sent. What is the most appropriate management?

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Correct answer: A — Corticosteroids with intravenous immunoglobulin because of clinically significant bleeding

Severe ITP with mucosal bleeding is treated with corticosteroids and IVIG for rapid platelet rise; platelet transfusion is reserved for life-threatening bleeding and works poorly alone.

Reference: Canadian hematology immune thrombocytopenia guidance