Abstract

IMBACHI SALAMANCA, ALEX; OROZCO BURBANO, JUAN  and  CORREA CORREA, MARIO. Refractory primary immune thrombocytopenia and use of combined therapy, case report. Salud, Barranquilla [online]. 2023, vol.39, n.2, pp.818-826.  Epub Apr 10, 2024. ISSN 0120-5552.  https://doi.org/10.14482/sun.39.02.400.573.

Primary immune thrombocytopenia is an acquired autoimmune disorder, characterized by platelet destruction, resulting from the production of antibodies against the platelet membrane, involving ahigh risk of bleeding for the patient. Currently, the cornerstone of treatment is the use of first-line agents such glucocorticoids and intravenous immunoglobulin. However, in some patients may be refractory to these agents, requiring the use of second and third line agents. We present the case of a 25-year-old female patient with a history of primary immune thrombocytopenia with severe presentation due to the presence of gastrointestinal bleeding and associated anemic state, with refractoriness to different treatment including splenectomy and the subsequent use of Rituximab, which was used to maintain an adequate platelet count. We consider that this case is of clinical interest given the scarce case reports of this condition and the limited evidence on sequential therapies in patients refractory to first line treatment.

Keywords : thrombocytopenia; hemorrhage; glucocorticoids; splenectomy; Rituximab; combined modality therapy.

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