Therapeutic Management of Immune Thrombocytopenia Case 2

Video

Therapeutic Management of Immune Thrombocytopenia

Case: A 44-year-old woman presenting with reddish-purple rash on lower legs

February 2017

  • Patient presents with complaints of a reddish-purple rash on her lower legs and “constant” bruises appearing “spontaneously” without her remembering any trauma
  • Physical evaluation reveals:
    • The rash to be petechiae (subcutaneous bleeding)
    • Slightly overweight (BMI = 26.5 kg/m2)
    • Patient is afebrile, with no splenomegaly
  • When asked, reports her menstrual flow is unusually heavy, but says she was evaluated for and had no evidence of fibroids or endometriosis
  • No personal or family history of cancer; no recent viral illnesses; no bone pain
  • Current medications: no chronic medications; acetaminophen as needed; multivitamin
  • Laboratory findings:
    • CBC reveals platelets 21 X 109/L
    • All other findings with normal range
    • Negative forH pylori, HIV, and HCV
  • Diagnosis: chronic ITP
    • Started course of prednisone 1 mg/kg X 21 days, then tapered off; at evaluation, platelets: 27 X 109/L
    • Second course of prednisone 1 mg/kg X 21 days; at evaluation, platelets still <30
    • Third course of prednisone 1 mg/kg X 21 days; at evaluation, platelets still <30

February 2018

  • &ldquo;Rash&rdquo; partly resolved, bruising still present
  • Patient complains of weight gain on treatment and trouble sleeping
  • After discussion with patient, she is started on eltrombopag (PROMACTA), at a dose of 50 mg/day
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