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

Rawad  Halimeh; Marianne  Bersaoui; Bernard  Najib; Joseph  Klim; Lea  Aoude; Wiam  Saab; Fadi  Fakhoury

doi:10.18502/jri.v26i1.18782

Rawad Halimeh The Centre for Reproductive and Genetic Health (CRGH), London, UK
Marianne Bersaoui Hospital Center of Antibes Juan-Les-Pins, Antibes, France
Bernard Najib Centre Antoine Lacassagne, Nice, France
Joseph Klim Faculty of Medicine and Medical Sciences, University of Balamand, El-Koura, Lebanon
Lea Aoude Faculty of Medicine and Medical Sciences, University of Balamand, El-Koura, Lebanon
Wiam Saab The Centre for Reproductive and Genetic Health (CRGH), London, UK
Fadi Fakhoury Department of Anesthesia, Montreuil Intercommunal Hospital Center, Montreuil, France

DOI: https://doi.org/10.18502/jri.v26i1.18782

Keywords: Bleeding, Immune thrombocytopenia, Immunoglobulins, Platelet count, Prednisolone, Preg-nancy, Purpura

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/mm³. 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.