Triggers and treatments for acute episodes of ITP

I'm writing this from a hospital in Mexico where my boyfriend is being treated for an episode of ITP...

His first episode occurred shortly after returning from Mexico in 2012. I noticed petechiae and packed him off to the dr (I thought he had meningitis!). Platelet count of 3K. Went to the hospital where he was treated with three vials of IVIg. His platelets went up to 400K and over the next year fluctuated between 150 and 300K.

The next year we again went to Mexico, and shortly after we returned the spots showed up again. 3K again, same treatment, same results.

We asked the haemotologist if Mexico might have been the culprit, she said no. We went to Mexico in 2014 and he did not see any signs of a lowered platelet count after returning (to be honest I don't even think ITP crossed his mind).

Fast forward to last week, in the middle of our Mexican vacation to visit his sister who lives here, petechiae show up in droves on his feet. We bus to the hospital and his platelet count is 38K. They don't do IVIg as a first response here, so he was on hydrocortisone (as he has gastroenteritis), and now prednisone because he stopped passing bloody stools.

Anyway, given that the IVIg treatments in the past have essentially 'cured' his ITP, his diagnosis would be acute each time, correct?

Upon reflection he had gastroenteritis (probably due to food-acquired bacterial infections) in Mexico before the other times ITP developed. Does this happen to anybody else with repeated acute ITP?

I know many who post here live with chronic ITP, did any of you have acute episodes before a more permanent onset?

Thanks!

AN illness can cause an acute case of ITP. If he is getting gastroenteritis every time he is in Mexico, I'd say that is the culprit. Most ITP patients never get 'cured' from IVIG; it usually only lasts a few days or weeks.

It would be impossible to say if these acute cases would lead to chronic ITP. Everyone is different.

Thanks for your reply.

Yeah, it's doubtful we will come back again.

From what I've read IVIg is as you say, a temporary fix for those with ITP, but after he has it, his platelets stay within a normal range. He had CBC's every month for a year after each time.

I suppose ITP and treatments affect each person differently, as we all have unique immune systems.

It seems as though he has acute episodes each time. I don't run across that very often. Illnesses can often bring counts down temporarily and it's possible that he would rebound on his own.