What additional treatment might be required for steroid-resistant cases of ITP?

In cases of Immune Thrombocytopenic Purpura (ITP) where patients do not respond to steroid therapy, splenectomy is often considered the next step in management. The spleen plays a crucial role in the destruction of platelets, particularly in the setting of ITP, where antibodies target platelets for destruction. By removing the spleen, this process is impeded, often leading to an increase in platelet counts and a reduction in bleeding risk.

Splenectomy is especially beneficial for patients with persistent or chronic ITP that is significantly impacting their quality of life and for whom other medical therapies, including steroids, have failed. This surgical intervention can result in a long-term resolution of thrombocytopenia in a significant number of individuals, thus making it a valuable option for treatment in resistant cases.

Other treatments, such as increasing steroid dosage or using immunosuppressants, might still be considered, but they may not be as effective for individuals who have already shown resistance to steroids. Bone marrow transplant, while potentially curative, is not typically performed in ITP due to its risk profile and the availability of less invasive options like splenectomy that are effective in many cases.