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一名孕33周患者的严重免疫性血小板减少性紫癜:病例报告

Severe Immune Thrombocytopenic Purpura in a Patient at 33 Weeks of Gestation: A Case Report.

作者信息

Halimeh Rawad, Klim Joseph, Aoude Lea, Bersaoui Marianne, Najib Bernard, Saab Wiam, Fakhoury Fadi, Skaf Rana

机构信息

Department of Obstetrics and Gynecology, Saint George Hospital University Medical Center, Beirut, Lebanon.

Faculty of Medicine and Medical Sciences, University of Balamand, El-Koura, Lebanon.

出版信息

J Reprod Infertil. 2025 Jan-Mar;26(1):58-63. doi: 10.18502/jri.v26i1.18782.

Abstract

BACKGROUND

Immune thrombocytopenia (ITP) is an autoimmune condition that affects individuals of all ages, leading to a heightened risk of bleeding. ITP accounts for 5% of all pregnancy-related thrombocytopenia cases with an incidence of 1 in every 1,000 pregnant women. Several conditions can cause thrombocytopenia during pregnancy, making the diagnosis challenging. Current treatment of patients with ITP focuses on maintaining a safe platelet count rather than correcting it to normal levels.

CASE PRESENTATION

This article presents a case of a 26-year-old patient at 33 weeks of gestation with severe symptoms of thrombocytopenia, evidenced by a platelet count of 1000/ . The patient experienced self-resolving episodes of gingival bleeding, vaginal bleeding, and petechiae on her abdomen, as well as on both upper and lower extremities, over a duration of three days. She was successfully managed with prednisolone and intravenous immunoglobulin (IVIG), resulting in favorable maternal and neonatal outcomes.

CONCLUSION

While there are currently no universally accepted guidelines for the treatment of ITP, expert consensus recommendations are available. Therefore, treatment should be individualized and closely monitored. A multidisciplinary team approach is essential for the effective management of ITP during pregnancy.

摘要

背景

免疫性血小板减少症(ITP)是一种自身免疫性疾病,可影响各年龄段人群,导致出血风险增加。ITP占所有妊娠相关血小板减少症病例的5%,每1000名孕妇中就有1例发病。孕期有几种情况可导致血小板减少,这使得诊断具有挑战性。目前ITP患者的治疗重点是维持安全的血小板计数,而非将其纠正至正常水平。

病例报告

本文介绍了一名26岁、孕33周的患者,其血小板计数为1000/ ,有严重血小板减少症状。患者在三天内出现牙龈出血、阴道出血、腹部以及上下肢瘀点等自行缓解的症状。她通过泼尼松龙和静脉注射免疫球蛋白(IVIG)成功得到治疗,母婴结局良好。

结论

虽然目前尚无普遍接受的ITP治疗指南,但有专家共识推荐。因此,治疗应个体化并密切监测。多学科团队方法对于孕期ITP的有效管理至关重要。

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