Treatment for ITP is recommended for a platelet count less than 30×109/L. Corticosteroids are considered first-line treatment, with the addition of IVIgG reserved for severe ITP and bleeding, when a rapid rise in platelets is required, or when corticosteroids are contraindicated. There is no evidence of benefit of IVIgG in combination with corticosteroids for first-line treatment of asymptomatic ITP. Unnecessary IVIgG infusions can result in multiple adverse effects, including acute hemolytic or anaphylactic reactions, infections, thromboembolic events, and aseptic meningitis.
Sources:
Health Quality Ontario. Intravenous immune globulin for primary immune thrombocytopenia: a rapid review [Internet]. 2014 [cited 2017 Jun 29].
Neunert C, et al. The American Society of Hematology 2011 evidence-based practice guideline for immune thrombocytopenia. Blood. Apr 21 2011;117(16):4190-4207. PMID: 21325604.
Neunert CE. Current management of immune thrombocytopenia. Hematology Am. Soc. Hematol. Educ. Program. 2013;2013:276-282. PMID: 24319191.
Provan D, et al. International consensus report on the investigation and management of primary immune thrombocytopenia. Blood. Jan 14 2010;115(2):168-186. PMID: 19846889.