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AbstractThisarticlesummarizesourapproachtothemanagementofchildrenandadultswithprimaryimmunethrombocytopenia(ITP)whodonotrespondto,cannottolerate,orareunwillingtoundergosplenectomy.WebeginwithacriticalreassessmentofthediagnosisandadeliberateattempttoexcludenonautoimmunecausesofthrombocytopeniaandsecondaryITP.Forpatientsinwhomthediagnosisisaffirmed,weconsiderobservationwithouttreatment.Observationisappropriateformostasymptomaticpatientswithaplateletcountof20to30×/Lorhigher.Weuseatieredapproachtotreatpatientswhorequiretherapytoincreasetheplateletcount.Tier1options(rituximab,thrombopoietinreceptoragonists,low-dosecorticosteroids)havearelativelyfavorabletherapeuticindex.WeexhaustallTier1optionsbeforeproceedingtoTier2,which白殿疯挂什么科白癜风有遗传吗 转载请注明原文网址：http://www.wkdmk.com/mbyjg/9221.html |
