Therapeutic Management of Immune Thrombocytopenia Case 1

Video

Therapeutic Management of Immune Thrombocytopenia

Case: A 48-year-old woman presenting with unusual bruising

October 2017

  • A 48-year-old woman presents with complaints of bruising after minor bumps, bleeding gums despite regular tooth cleaning, and a recent spontaneous bloody nose; symptom onset about 1 year ago
  • Physical evaluation reveals a woman of normal weight and average height, afebrile, no splenomegaly
  • No personal or family history of cancer, autoimmune disease; no recent viral illnesses; no bone pain or night sweats
  • Current medications: ibuprofen as needed, generic hydrochlorothiazide (HCTZ)
  • Laboratory findings:
    • CBC reveals platelets 28 X 109/L
    • WBCs within normal
    • Renal and hepatic function within normal
  • Diagnosis: idiopathic thrombocytopenic purpura
  • Patient started on a course of prednisone 1 mg/kg for 21 days, then tapered off
    • Platelets: 29 X 109/L
    • Second course of prednisone 1 mg/kg for 21 days

April 2018

  • After 2 courses of prednisone, patient’s platelets have not recovered
    • CBC shows platelets at 28 X 109/L
  • Symptoms of easy bruising and bleeding from gums continue
  • After discussion with patient, she is started on the thrombopoietin receptor agonist (TPO-RA) eltrombopag (PROMACTA), at a dose of 50 mg/day
    • Dose increased to 75 mg/day; last platelet count, 65 X 109/L
Recent Videos
Corey Cutler, MD, MPH, and Hannah Choe, MD, experts on GVHD
Corey Cutler, MD, MPH, and Hannah Choe, MD, experts on GVHD
Corey Cutler, MD, MPH, and Hannah Choe, MD, experts on GVHD
Hannah Choe, MD, an expert on GVHD
Corey Cutler, MD, MPH, an expert on GVHD
Corey Cutler, MD, MPH, and Hannah Choe, MD, experts on GVHD
Corey Cutler, MD, MPH, and Hannah Choe, MD, experts on GVHD
1 KOL is featured in this series.
Guillermo Garcia-Manero, MD, an expert on MDS
Related Content