Refractory severe immune thrombocytopenia in a twin pregnancy

Patrick Harrington; Catherine Nelson-Piercy; Catherine Williamson; Nichola Cooper; Rachel Kesse-Adu; Susan Robinson

doi:10.1177/1753495X17709188

Refractory severe immune thrombocytopenia in a twin pregnancy

Patrick Harrington^*, Catherine Nelson-Piercy, Catherine Williamson, Nichola Cooper, Rachel Kesse-Adu, Susan Robinson

^*Corresponding author for this work

Women & Children's Health

Imperial College London

Research output: Contribution to journal › Article › peer-review

9 Citations (Scopus)

Abstract

A 34-year-old woman presented at 29 weeks gestation of a twin pregnancy, with a platelet count of 1 × 10⁹/l. She was extensively investigated and was subsequently diagnosed with severe immune thrombocytopenia. She did not respond to initial treatment with corticosteroids and intravenous immunoglobulin. She also failed to respond to second-line therapies of Anti-D immunoglobulin, Azathioprine and the thrombopoietin agonist Romiplostim. Her case was further complicated by an episode of obstetric cholestasis possibly related to Azathioprine treatment. She went on to require plasma exchange around the time of an elective Caesarean section which provided temporary improvement in the platelet count and enabled safe delivery. This case highlights some of the challenges faced in the management of patients with severe and refractory immune thrombocytopenia during pregnancy.

Original language	English
Pages (from-to)	35-38
Number of pages	4
Journal	Obstetric Medicine
Volume	11
Issue number	1
Early online date	10 Jul 2017
DOIs	https://doi.org/10.1177/1753495X17709188
Publication status	Published - 1 Mar 2018

Keywords

Haematology
high-risk pregnancy
immunology
multiple pregnancy

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AU - Cooper, Nichola

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Refractory severe immune thrombocytopenia in a twin pregnancy

Abstract

Keywords

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