Bleeding crisis in acute idiopathic thrombo-cytopenic purpura is managed by all except –
**Core Concept**
Acute idiopathic thrombocytopenic purpura (AITP) is a condition characterized by isolated thrombocytopenia due to autoimmune destruction of platelets. In a bleeding crisis, the primary goal is to rapidly increase platelet count to prevent further bleeding.
**Why the Correct Answer is Right**
The management of bleeding crisis in AITP involves administering corticosteroids to reduce platelet destruction and increase platelet production. Corticosteroids work by inhibiting the production of autoantibodies against platelets and reducing the activation of the immune system. Additionally, corticosteroids can also decrease the release of histamine and other mediators that contribute to platelet destruction.
**Why Each Wrong Option is Incorrect**
**Option A:** Platelet transfusions are not recommended as the primary treatment for bleeding crisis in AITP, as they can worsen the condition by accelerating platelet destruction.
**Option B:** Intravenous immunoglobulin (IVIG) is a treatment option for AITP, but it is not the first-line treatment for bleeding crisis. IVIG works by saturating the Fc receptors on macrophages and dendritic cells, thereby reducing the clearance of platelets.
**Option C:** Splenectomy is a treatment option for chronic AITP, but it is not used to manage acute bleeding crises. Splenectomy is typically considered for patients with severe or refractory disease.
**Clinical Pearl / High-Yield Fact**
In AITP, the bleeding time is typically normal or prolonged, despite the presence of thrombocytopenia. This is because the bleeding time is more sensitive to the function of platelets rather than their absolute count.
**Correct Answer:** A. Platelet transfusions