Abstract
Thrombocytopenia can be caused by various etiologies, one of which is immune-mediated destruction. Within the realm of immune thrombocytopenia, there can be multiple pathways and mechanisms that lead to platelet destruction. Finding the exact mechanism can be a crucial diagnostic step in deciding the most appropriate treatment of the platelet loss and in the therapeutic planning of a patient's comorbidities, especially in patients with malignancies. In this case report, we describe a patient with metastatic clear cell renal cell carcinoma who developed acute thrombocytopenia while preparing to initiate therapy for his malignancy.