Abstract
We describe a rare case of a 64-year-old male who developed life-threatening thrombocytopenia two weeks after undergoing endovascular aneurysm repair (EVAR) for an abdominal aortic aneurysm. He presented with mucocutaneous bleeding manifestations, and laboratory findings revealed a critically low platelet count (<2 × 10(9)/L). An extensive workup identified a positive Helicobacter pylori stool antigen test and autoimmune markers, including antinuclear antibody (ANA) and anti-double-stranded DNA (anti-dsDNA) antibodies. The close temporal relationship with EVAR initially raised concern for procedure-related complications, such as heparin-induced thrombocytopenia, although this was ultimately ruled out. Given the severity and refractoriness of thrombocytopenia to steroids alone, intravenous immunoglobulin (IVIG) was added. The patient's platelet counts improved following combined corticosteroid, IVIG, and Helicobacter pylori eradication therapy. This unusual confluence of a recent vascular procedure, infectious, and autoimmune triggers highlights a rare and diagnostically challenging case of secondary immune thrombocytopenia (ITP), emphasizing the need for comprehensive evaluation and tailored management in similar clinical scenarios.