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)
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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.