Thrombocytopenia is a condition that develops from having a low platelet count. Treatment options include platelet transfusions, corticosteroids, and intravenous immunoglobulin.

Platelets are cells that help your blood clot when a blood vessel is injured. Having a low number of platelets can increase your risk of dangerous bleeding.

Treatments for thrombocytopenia depend on the severity of the condition and its underlying cause. In certain cases, platelet transfusion can be given for thrombocytopenia with bleeding or for a critically low platelet count in which a person is at risk for bleeding.

However, in rare instances, a platelet transfusion can worsen the underlying disease causing thrombocytopenia. For example, if the underlying disease is thrombotic thrombocytopenic purpura (TTP), a rare blood disorder that causes blood clots to form throughout the body.

This article reviews treatment goals and treatment options for thrombocytopenia.

The primary goal of treating thrombocytopenia is to replace the platelets that you’re lacking in your blood.

But replacing platelets isn’t always the answer. Sometimes, treatments also focus on helping your body produce more platelets or keeping your immune system from destroying the platelets you do produce.

When you lack platelets, the most direct treatment is to replace them with a transfusion of donated platelets. How well this treatment works depends on what’s causing your thrombocytopenia.

For example, if your thrombocytopenia is caused by an autoimmune disorder, it means that your body is attacking its own platelets. In this case, platelet replacements may help to initially relieve your symptoms, but your body will still attack the donated platelets.

This is why some people with thrombocytopenia who have platelet transfusions may also need other kinds of treatments to suppress the action of their immune systems.

Potential risks or side effects

The primary risk of having a platelet transfusion is the same as with any other blood product. Even though testing is done prior to being given any transfusion to match the compatibility in donor and recipient blood, there’s always a chance you could develop a reaction to donated platelets and other types of blood cells.

Signs or side effects of a transfusion reaction can include:

  • itching
  • rash
  • heart rate changes
  • blood pressure changes
  • fever
  • breathing problems

Additionally, although blood products undergo many levels of testing and preparation after donation, there’s a chance you develop a bacterial or viral infection after a transfusion.

Certain medications can help your body produce more platelets. These medications include thrombopoietin receptor agonists (TPO-RAs), which stimulate the creation of new platelets and increase how quickly new platelets are made in the body. Examples of medications that fall into this category include:

Potential risks or side effects

The main problem associated with the use of TPO-RAs is liver damage. It’s not clear exactly how these medications damage liver tissue, but some degree of liver damage is possible with medications in this category.

Corticosteroids are medications that suppress your immune system. Examples include medications like prednisone and dexamethasone. These medications are the primary and emergency treatment for people with thrombocytopenia caused by a malfunction of the immune system.

In immune thrombocytopenia, your body attacks your platelets. Corticosteroids help to limit the destructive activity of your immune system and decrease the number of platelets that your body destroys.

If corticosteroids aren’t an option or the immune system doesn’t respond to steroids, other medications may be used to decrease the reaction of your immune system, including:

Potential risks or side effects

There are side effects of immunosuppressants, including corticosteroids:

  • opportunistic infections of illnesses related to your immune system suppression
  • increases in blood glucose
  • swelling
  • muscle weakness
  • bruising
  • headache
  • vomiting or upset stomach
  • anxiety or restlessness

Intravenous immunoglobulin (IVIG) is an intravenous therapy. It’s created using antibodies that can help treat infections, inflammation, and various autoimmune disorders. There are several varieties of IVIG infusions, and your doctor will choose the right preparation for your specific condition.

In most cases, you’ll stay in the hospital for a short period of time while you receive your IVIG infusion, plus additional time for monitoring afterward. Most reactions that develop after IVIG therapy occur about an hour after the infusion starts.

IVIG doesn’t have the same effect on everyone. In addition to monitoring for reactions, your doctor will want to observe you after your infusion to see how much of an effect the treatment had on your condition. The effects of an IVIG infusion can last for several weeks.

Potential risks or side effects

One of the main risks of IVIG therapy is an allergic or transfusion reaction to the antibodies you are given. Careful screening is done prior to the transfusion to try and minimize this risk, but it’s still a possibility. For this reason, you’ll be monitored closely during IVIG infusion and for a period of time after.

The most common problems that develop during or after IVIG therapy include:

  • headache
  • fever
  • chills
  • vomiting
  • chest pain
  • back pain
  • fatigue
  • skin flushing

While most side effects of IVIG are mild, older people who receive this therapy are at a greater risk of more severe reactions like:

Thrombocytopenia is a condition where, for one reason or another, your body lacks an adequate amount of platelets.

A platelet transfusion is sometimes needed to improve the platelet count to a safe range. However, depending on the cause or type of thrombocytopenia you have, you may require other treatments, as platelet transfusions don’t treat the underlying cause of thrombocytopenia.

For example, you may need medications that stimulate platelet production or reduce autoimmune destructive activity.

Talk with your doctor about your specific form of thrombocytopenia and what treatment or treatments can give you the best results.