Refractory Primary Immune Thrombocytopenia With Bleeding and Thrombosis: A Case Report - PubMed
7 days ago
- #bleeding and thrombosis
- #immune thrombocytopenia
- #personalized treatment
- A 50-year-old male with primary immune thrombocytopenia (ITP) presented with bleeding and thrombosis risks.
- Patient had a history of cerebral ischemia and smoking, complicating treatment due to dual bleeding and thrombosis risks.
- Initial treatments (prednisone, vincristine, anti-D immunoglobulins) were ineffective, leading to cerebral hemorrhage.
- Splenectomy and rituximab showed only partial response; romiplostim caused myocardial ischemia.
- Immunosuppressants (azathioprine, mycophenolate mofetil) and other therapies (eltrombopag, bortezomib, dapsone) failed.
- Avatrombopag at 20 mg daily with dual antiplatelet therapy finally achieved good platelet response.
- Case highlights the complexity of ITP management, requiring personalized treatment balancing bleeding and thrombosis risks.