Acute: Children with no bleeding or mild bleeding only (mild bruising or petechiae) should be managed with observation alone regardless of platelet count.
For children with moderate to severe mucosal and/or cutaneous bleeding and platelet count less than 30 x 109/L, IVIG can be used.
Chronic: IVIG can be used in chronic ITP for previous responders.
For patients who require treatment, a single dose of IVIG may be considered a front-line treatment (0 .8 to 1 g/kg). A second dose can be repeated if there is no clinical response. IVIG will result in a faster increment in platelet count compared with steroids. In emergent management, IVIG is recommended as part of multimodal therapy.