Shaw Taylor B, Ma Brenda, Barazza Mark, Sawaya David
Department of Surgery, University of Mississippi Medical Center, Jackson, MS, USA.
Department of Surgery, Division of Pediatric Urology, University of Mississippi Medical Center, Jackson, MS, USA.
Am Surg. 2023 Nov;89(11):4884-4887. doi: 10.1177/00031348211011128. Epub 2021 Apr 18.
Immune thrombocytopenic purpura (ITP) is a disorder caused by autoimmune antibodies which target glycoprotein IIb/IIIa complex or other platelet membrane antigens leading to platelet destruction. These platelets are then cleared by the spleen resulting in thrombocytopenia. Immune thrombocytopenic purpura affects about 1 to 6.4 cases in 100 000 children making it one of the most common causes of symptomatic thrombocytopenia in the pediatric population. It is rare that children or adolescents present with serious bleeding due to ITP. Common presentations include petechiae, bleeding gums, or bruising. Bleeding requiring hospitalization or transfusions is unusual and only occurs in approximately 5% of children. Even more uncommon is the presentation of severe bleeding complications requiring surgery for resolution. We present a case of a 17-year-old girl with acute ITP complicated by intraperitoneal hemorrhage and refractory thrombocytopenia due to ovarian cyst requiring oophorectomy.
