In adults with ITP and severe mucosal bleeding, which treatment is used for acute control?

• A. Corticosteroids
• B. IVIG
• C. Splenectomy
• D. Platelet transfusion

Answer: (B)

When rapid control of active mucosal bleeding in immune thrombocytopenia is needed, the quickest way to lift the platelet count is to use IV immunoglobulin. IVIG works by saturating Fc receptors on macrophages and blocking the destruction of antibody-coated platelets, which leads to a rise in platelets within about 24 to 48 hours. This fast response is crucial for stopping mucosal bleeding.

Corticosteroids can help, but their effect on platelet counts develops more slowly, making them less ideal for urgent control. Platelet transfusion is often not effective in ITP because the transfused platelets are rapidly destroyed by the circulating autoantibodies. Splenectomy can reduce platelet destruction long-term but is not a rapid solution for acute bleeding.