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

妊娠33周患者发生重度免疫性血小板减少性紫癜:病例报告

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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/mm (3). 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.

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