If IVIG works well, it works temporarily, but can be a good rescue treatment in the event of a bleed or really dangerously low count. It has side effects, however, that are not to be discounted. My daughter's first IVIG treatment (for her first count under 20,000, but, nowadays, they might wait until lower) raised her counts quickly, and they stayed up for a while before gradually decreasing over the weeks after. Within 24 hours of discharge, however, she landed back in the hospital with "the worst headache of my life." (These are ER red flag words for head bleed.) She had migraines before, but this was much worse. It is aseptic meningitis, meaning an irritation of the brain membrane caused by something other than viral or bacterial infection. She was observed for 24 hours, had a head scan, and was treated symptomatically. She had been premedicated with benadryl and tylenol for the infusion, but that was not kept up during and after. We learned from folks here that the side effects may be lessened by good hydration throughout the infusion and after, benadryl and tylenol before and during the infusion, continuing the benadryl after the infusion for a day, and a decadron (solumedrol) shot at discharge or pills for a couple days. She had IVIG again for a count of 3,000, and the side effects were minimal with this approach. The third time she had IVIG was for a nonstop nosebleed when her counts plummeted after our first trial of decadron pulse therapy. (She tolerated the low count well, generally, but this time I think it was the fast drop that did it.) IVIG is also terribly expensive. Sticker price, before insurance discount and payment, was over $20,000 for one night in the hospital and IVIG. (Our docs do that inpatient, so the patient can be closely observed for infusion reaction.) And, although it is well screened and actually detergent cleaned, IVIG is made from the pooled plasma of many donors, so it is a blood product, and that is not without its risks. Many years ago, some patients contracted hepatitis C from IVIG, just as they could have from a blood transfusion, but screening is much better now. (Don't want to scare anyone off IVIG - it's a wonderful rescue, for which we were grateful. I know of no hepatitis or other issues since the early 1990s, but no such product can be 100% risk free.) Watch and wait is frustrating, to the patient and the mother, but, provided the count doesn't go dangerously low and there are no bleeds, it is a "treatment option" without side effects.
How old is Aleena? The younger the age, the more likely that she will be an acute case, and back to normal soon. There are tips on here to help manage at various ages. (Some folks put bike helmets on their toddlers.) There is a tab somewhere on the site about managing ITP and sports. My daughter was just under 13 when diagnosed. ITP can restrict sports and other activities like skating and bicycling, and it can also cause some misery with a certain issue in pubescent girls. We had our miserable weepy days, but mostly we managed fine with watch and wait. (And, regardless of what some docs say, kids with ITP can get really fatigued, sleep-disturbed, and grumpy.) Within about three years, she went into spontaneous remission. It happens, so take heart. She is now almost 20 years old, and quite healthy. She was able to resume sports and all her normal activities. Even with low counts, she could play mild tennis in middle school except when the counts were below 30.
You've already done the right thing, by using a pediatric hematologist. (Other docs seem to eager too "fix" it.) There are patients, moms, and spouses here that can help you greatly while you go through this. It really helped me. Good luck with this.
Norma
