An autoimmune disease called immune thrombocytopenic purpura (ITP) affects roughly 1 in 10,000 people worldwide. A platelet count of less than 100 x 109L has historically been used to describe it, however symptoms are more often used to guide treatment than the actual platelet count. Corticosteroids have traditionally been the first line of treatment for patients with primary idiopathic ITP, with intravenous immune globulin (IVIG) or Rho(D) immune globulin (anti-RhD) being added for steroid-resistant instances. Second-line treatment options for ITP include splenectomy or rituximab, a monoclonal antibody that targets the CD20 antigen (anti-CD20).. The diagnosis of "chronic refractory ITP" is warranted in patients who continue to experience severe thrombocytopenia and symptomatic bleeding despite first- and second-line therapies, and third-line therapies are considered.