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reatment of newly diagnosed primary immune thrombocyopenia (ITP) is aimed at obtaining a safe platelet count in rder to prevent major bleeding with minimal side effects. reatment is recommended for patients with a platelet count f <30,000 platelets/mm3, associated with bleeding or <20,000 latelets.1 The American Hematology Society (ASH) 2011 guidelines2 ecommend oral prednisone 1 mg/kg/day for 21 days and ubsequently tapered off, rather than dexamethasone 40 mg ntravenous/oral for 4 days every two weeks. In case of hemrrhage, intravenous immunoglobulin (IVIG) 1gm/kg/day for wo days is recommended.2 Platelet transfusions for lifehreatening bleeding have a better response if used after IVIG nfusion due to increased platelet survival.2 For patients who o not respond to steroids/IVIG, intravenous dexamethasone

Short-term dose-escalated romiplostim for preparing an adult patient with persistent newly diagnosed primary immune thrombocytopenia for splenectomy