<s>[INST] Hello DR., my niece 10yrs old girl have low platelet issue since last 18 months, as DR s chronic ITP case, we gone thru lot of treatment in Sir GangaRam, AIMS & in Homoepathy... last 8-10 months were ok like platelet count was btw 10k to 50k, but some time no black spot on body some time raise to much, yest she has bleeding from nose and spots in mouth... dont know wat to go,,, Plz suggest some treatment/Dr anywhere in India [/INST] Hello dear. As you said she is a case of chronic ITP, i would like to ask, has she been screened for autoimmune diseases like SHE?or chronic infections like HIV? I hope she has been given IVG and corticosteroids during the acute phase...???you can go for anti-D and /or rituximab after your doctors advise. You should also talk about splenectomy to your daughters treating physician, as about 64-88 % child Chat Doctor. Ask your daughters treating physician about the availability of romiplastin and eltrombopag in your country and the data regarding their success rate. Hope it will help. Wishing your child good health :-) </s>