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Hi, let’s discuss #ITP! Pls respond the poll and see the thread below. #bloodbank #blooducation
How comfortable you feel with a platelet of 1 thou/uL in a case of ITP. Would you transfuse platelets with mild gingival bleeding in an otherwise asymptomatic pt?
How comfortable you feel with a platelet of 1 thou/uL in a case of ITP. Would you transfuse platelets with mild gingival bleeding in an otherwise asymptomatic pt?
If you do give platelets, what would you be your threshold for transfusion. Remember patient has mild gingival bleed.
Would it change if patient was completely asymptomatic (no gingival bleed at this time).
What threshold you would use?
Thank you for participating of this poll. I do not have an exact answer. It varies a lot, depending on the clinical practice. 
https://abs.twimg.com/emoji/v2/... draggable="false" alt="👇" title="Down pointing backhand index" aria-label="Emoji: Down pointing backhand index"> https://pubmed.ncbi.nlm.nih.gov/30520045/ ">https://pubmed.ncbi.nlm.nih.gov/30520045/...
ITP causes immune destruction of platelets. Platelet transfusions are relatively contraindicated since they will be destroyed anyway. However, there is some discussion about using a threshold to decrease risk of spontaneous bleed.
This was a real case, patient was transfused, but in addition, he was also treated with IVIg. So now, let’s discuss treatment.
Management of newly diagnosed ITP in adult patients w/ plt <30thou/uL involves corticosteroids, IVIg, platelet transfusions, RhIg. There are other treatments, but these are usually first line. Combination therapies are important to raise plt count fast (usually IVIg + steroids)
In severe hemorrhage, transfusion support is essential and should be given. Platelet drip with continuous infusion can also be given if patient fails to respond to individual units.
Did you know that slow infusions of IVIg concomitantly or followed by platelet transfusions is believed to increase the survival of platelets in ITP? So, here it goes another paper https://abs.twimg.com/emoji/v2/... draggable="false" alt="👇" title="Down pointing backhand index" aria-label="Emoji: Down pointing backhand index"> https://pubmed.ncbi.nlm.nih.gov/17874448/?from_single_result=Treatment+of+immune+mediated+thrombocytopenia+p%C3%BArpura+with+concurrent+intravenous&expanded_search_query=Treatment+of+immune+mediated+thrombocytopenia+p%C3%BArpura+with+concurrent+intravenous">https://pubmed.ncbi.nlm.nih.gov/17874448/...
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Tagging @HermelinMD @ksticcoMD @bloodbankguy @AShmooklerMD @ChrisTormey3 @G_GUPTAMD @Dr_RoryShallis @TalibDosaniMD @BenignHeme
Tagging @HermelinMD @ksticcoMD @bloodbankguy @AShmooklerMD @ChrisTormey3 @G_GUPTAMD @Dr_RoryShallis @TalibDosaniMD @BenignHeme
