What is the best practice for a patient diagnosed with ITP that does not respond to steroid treatment?

In patients diagnosed with immune thrombocytopenic purpura (ITP) who do not respond to steroid treatment, the best practice is to consider splenectomy. The spleen plays a critical role in the destruction of platelets that are mistakenly targeted by the immune system in ITP. By removing the spleen, the underlying autoimmune activity that leads to platelet destruction can potentially be reduced or eliminated, often resulting in an improvement in platelet counts.

Continuing steroid therapy indefinitely is not advisable for patients who do not respond to it, as prolonged steroid use can lead to significant side effects without any therapeutic benefit in managing their condition.

Switching to antiviral medications is not relevant in the management of ITP, as this condition is not caused by a viral infection, and antiviral treatments do not address the problem of platelet destruction.

Performing blood transfusions is not a standard treatment for ITP, as blood transfusions primarily address acute bleeding issues rather than the underlying low platelet count resulting from the autoimmune process. Therefore, the most appropriate step for a patient who does not respond to steroids is to evaluate the possibility of splenectomy as a treatment option.