How do you approach the treatment of ITP in a pregnant patient who did not respond to prednisone?

We usually stay away from dex because of the toxicity and use the absolutely smallest dose of prednisone we can. Usually, unless the count is very low, I start at about 20mg since we’re just trying to get the count up not get a CR.

We manage a lot of patients with IVIg alone, but it can get expensiv...