Case of severe thrombocytopenia with recurrent extensive deep vein thrombosis due to antiphospholipid syndrome, management challenge

Severe thrombocytopenia in secondary antiphospholipid syndrome (APS) presents a significant management challenge. This case highlights the complexity of managing APS-related thrombocytopenia, requiring a nuanced approach to balancing bleeding and thrombotic risks. Intravenous immunoglobulin, followed by a short course of steroids, successfully increased platelet counts without adverse bleeding or thrombotic events. Initiating therapeutic anticoagulation with Warfarin was delayed until platelet counts exceeded 50 × 10^3/μL, emphasizing the cautious approach required in such cases to mitigate thrombotic risks while avoiding bleeding complications.