If your platelet count drops very low, your doctor may recommend intravenous immunoglobulin (IVIG) to raise it quickly. IVIG is often used when there’s a high bleeding risk or a fast increase in platelet count is needed.

IVIG can temporarily reduce the immune system’s destruction of platelets in people with immune thrombocytopenia (ITP). You might also hear ITP referred to by its older name, immune thrombocytopenic purpura.

Here’s how IVIG works, when it’s used, and what to expect during treatment.

🗳️ Have you received intravenous immunoglobulin (IVIG) for immune thrombocytopenia (ITP)?

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What Is IVIG, and How Does It Raise Platelet Counts?

IVIG is a concentrated solution of immunoglobulin G (IgG), a type of antibody collected from thousands of healthy donors. It’s given through an IV line (into a vein) to help slow an immune system’s attack on platelets.

In ITP, the immune system may make antibodies that mistake platelets for a threat. When platelet counts are low, bruising and pinpoint red, purple, or brown spots called petechiae may appear on the skin.

IVIG floods the bloodstream with donor IgG antibodies that can interfere with the immune system’s destruction of platelets. Platelet counts often start increasing within a day or two.

IVIG doesn’t fix the underlying immune problem, though. It can raise platelet counts quickly, but the effect is usually temporary, so IVIG is not a cure.

What Happens During IVIG Treatment?

Once your doctor recommends IVIG, here’s what treatment typically looks like — from the infusion itself to the weeks that follow.

The Infusion Process

IVIG is given into the vein, usually at an infusion center or a clinic. A nurse starts the infusion slowly and speeds it up gradually to help reduce side effects.

A full infusion can take several hours, so you may want to bring something to keep you occupied. Depending on your treatment plan, you may receive IVIG on one day or over several days.

How Quickly Platelets Respond

One reason doctors use IVIG is speed. In about 70 percent to 80 percent of people with ITP, platelet counts start to rise within a day or two, although not everyone responds.

IVIG generally raises platelet counts faster than steroids alone. Follow-up blood tests show how your platelet count responds to treatment.

How Long the Benefit Lasts and Repeat Treatments

The platelet boost from IVIG typically doesn’t last. Counts often drop again within a few weeks.

Some people need repeat infusions or another treatment if their platelet count drops again. Your doctor can help you decide what approach makes sense for you.

How Does IVIG Compare With Other ITP Treatments?

IVIG is just one of several ITP treatments. Others work in different ways and may be used at different stages.

Corticosteroids

Corticosteroids, or steroids, are usually the first-line treatment for adults with newly diagnosed ITP who need treatment. Prednisone is taken daily, while dexamethasone is usually given in short, high-dose courses and may raise platelet counts faster.

For critical bleeding, doctors may use an IV steroid called methylprednisolone, often with IVIG and other treatments. Steroids can cause side effects, and longer use increases risks such as bone thinning and high blood sugar.

Thrombopoietin Receptor Agonists

Thrombopoietin receptor agonists (TPO-RAs) help the bone marrow make more platelets. TPO-RAs are usually considered for adults after first-line treatment hasn’t provided a lasting response.

TPO-RAs include pills and a weekly injection under the skin. These medications can increase the risk of blood clots.

Rituximab

Rituximab targets certain immune cells involved in making antibodies that attack platelets. It’s given by infusion over several weekly sessions and can lead to a longer-lasting response. Rituximab may take several weeks to work, so it isn’t generally used by itself when a rapid increase in platelet count is needed.

Possible side effects include infusion reactions and infections. Rituximab can also reduce the body’s response to vaccines.

Splenectomy

The spleen removes many antibody-coated platelets from the blood, so removing the spleen — a surgery called splenectomy — can provide a long-lasting increase in platelet counts for some people. However, splenectomy permanently raises the risk of blood clots and certain infections.

When possible, doctors delay splenectomy for at least a year after diagnosis, since ITP sometimes improves on its own during that time. The decision depends on factors such as how long someone has had ITP, previous treatments, bleeding risk, and their treatment preferences.

Your Action Plan for IVIG and ITP

IVIG offers a fast, temporary way to raise platelet counts in ITP. It may be used for severe bleeding, before an urgent procedure, or in other situations when speed matters — not as an everyday, long-term treatment.

Before your next appointment, write down your recent platelet counts, any bruising or bleeding you’ve noticed, and your current medications and supplements. Walking in prepared can make it easier to talk with your care team about what comes next.

Every case of ITP is different, and there’s no single treatment that’s right for everyone. The best treatment for you — whether that’s IVIG, steroids, a TPO-RA, rituximab, splenectomy, or another option — depends on factors such as your bleeding symptoms, platelet count, previous treatments, other health conditions, and your preferences.

Talk with your hematologist about which treatment approach makes the most sense for you.

Join the Conversation

On myITPteam, people share their experiences with immune thrombocytopenia, get advice, and find support from others who understand.

If you’ve been through IVIG or another ITP treatment, what would you want to share with someone who’s newly diagnosed? Let others know in the comments below.