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Case report
Romiplostim for management of refractory immune thrombocytopenic purpura in the immediate postpartum period
  1. Ariana Patras1,
  2. Reinaldo Figueroa1,
  3. Amit P Singh2,3 and
  4. Ichchha Madan1
  1. 1Department of OB/GYN, Trinity Health of New England, Hartford, Connecticut, USA
  2. 2Department of Nephrology, Trinity Health of New England, Mercy Medical Center, Springfield, Massachusetts, USA
  3. 3Department of Nephrology, Baystate Medical Center, Springfield, Massachusetts, USA
  1. Correspondence to Dr Ichchha Madan; ichchha.madan{at}


We present a case of a pregnant woman with chronic immune thrombocytopenic purpura and chronic hypertension who developed pre-eclampsia with severe features warranting delivery. Her overall clinical picture and liver enzymes improved in the immediate postpartum period, however, aggressively progressing thrombocytopenia posed a diagnostic dilemma to the interdisciplinary care team. After failing to respond to first-line therapies including high-dose corticosteroids and intravenous immunoglobulin, she was successfully managed with a trial of the thrombopoietin receptor agonist, Romiplostim.

  • obstetrics, gynaecology and fertility
  • haematology (incl blood transfusion)
  • pregnancy

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  • Contributors AP: OMS-IV: chronicled the patient’s treatment course through EMR documentation; gathered supporting papers referenced throughout the paper; wrote the case report; recorded references in requested format. RF and APS: literature review, wrote and proofread the case report. IM: part of the care team of patient, inception of the idea, summarised the case with the medical student, obtained consent from patient; assisted author 1 in literature review and wrote the case report; proofread the case report and submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.