Malik Tahreem, Capahi Marion
Department of Internal Medicine, Health Corporation of America Healthcare/University of South Florida Morsani College of Medicine Graduate Medical Education: Health Corporation of America Citrus, Inverness, USA.
Cureus. 2025 Jun 13;17(6):e85927. doi: 10.7759/cureus.85927. eCollection 2025 Jun.
Immune thrombocytopenic purpura (ITP) is an acquired autoimmune disorder characterized by the destruction of platelets due to autoantibodies, leading to an increased risk of bleeding. This case report describes a 77-year-old female who presented with acute gastrointestinal bleeding, severe thrombocytopenia, and mucocutaneous purpura. Initial laboratory evaluation revealed a critically low platelet count of <5 ×10³/μL, prompting urgent management with platelet transfusions, intravenous corticosteroids, and intravenous immunoglobulin (IVIG). Despite initial treatment, her thrombocytopenia persisted, necessitating the administration of the thrombopoietin receptor agonist romiplostim, which led to sustained platelet recovery. Further investigations revealed a recent history of an upper respiratory infection treated with antibiotics and newly diagnosed hepatitis C, highlighting potential infectious and medication-related triggers. This case underscores the complexity of ITP diagnosis and management, emphasizing the need for individualized treatment strategies, particularly in cases of severe bleeding. It also reinforces the importance of early recognition and timely intervention to prevent life-threatening complications.
免疫性血小板减少性紫癜（ITP）是一种获得性自身免疫性疾病，其特征是由于自身抗体导致血小板破坏，从而增加出血风险。本病例报告描述了一名77岁女性，她出现急性胃肠道出血、严重血小板减少和皮肤黏膜紫癜。初始实验室评估显示血小板计数极低，<5×10³/μL，促使紧急进行血小板输注、静脉注射皮质类固醇和静脉注射免疫球蛋白（IVIG）治疗。尽管进行了初始治疗，她的血小板减少仍持续存在，需要给予血小板生成素受体激动剂罗米司亭，这导致血小板持续恢复。进一步调查发现她近期有上呼吸道感染史，曾用抗生素治疗，且新诊断为丙型肝炎，突出了潜在的感染和药物相关触发因素。本病例强调了ITP诊断和管理的复杂性，强调了个体化治疗策略的必要性，特别是在严重出血的情况下。它还强化了早期识别和及时干预以预防危及生命并发症的重要性。
