A 29-year-old woman with persistent thrombocytopenia
Dr. Di Pasquale, Dr. Boscaro: In November 2013, a 29-year-old Moldovan woman was referred to our center with a platelet count of 4 × 109/L and bleeding symptoms such as epistaxis and petechiae. She had been diagnosed with immune thrombocytopenia (ITP) in 2002. Ever since her childhood, her thrombocytopenia had been associated with hemolytic anemia (Evans syndrome) requiring blood transfusions, and complicated by HCV-related hepatitis (anti-HCV antibodies, HCV-RNA 1257491 IU/ml, genotype 1b). Previous therapy for ITP, based on prednisone, intravenous immunoglobulin (IVIg) and azathioprine had been ineffective. In 2006, she underwent splenectomy, and achieved a stable complete remission (CR), maintained with a low daily dose of prednisone (2.5 mg).
She also suffered from Sjögren’s syndrome, with severe dry eyes, positive ANA and ENA anti-SSA titers, and monoclonal gammopathy of undetermined significance IgGK without Bence-Jones proteinuria.
Compliance with ethical standards
Conflicts of interest
The authors have no conflicts of interest to disclose.
Statement of human and animal rights
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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