Immune (idiopathic) thrombocytopenic purpura with COVID-19 infection diagnosed in pregnancy and management: a case report

Abstract

Immune (idiopathic) thrombocytopenic purpura (ITP), an autoimmune disease characterized by destruction of platelets, is a hematological disorder that can present in both pregnant and non-pregnant patients. It can occur in any trimester but generally, platelet counts start to decline in early pregnancy and continue to decline until delivery. Unlike most pregnancy-related thrombocytopenia, which is usually mild, ITP can have devastating consequences for mother, fetus, and neonate. It is a diagnosis of exclusion, and management should be based on a multidisciplinary care approach. ITP in pregnancy requires careful monitoring and may need treatment to improve platelet counts before delivery. Corticosteroid is the most commonly used first-line therapy to stop further destruction of platelets. Here, we report a case of a 26-year-old multigravida with gestational age of 24 weeks, diagnosed with ITP during routine antenatal check-up. Patient was managed with various treatment combinations consisting of platelet transfusion, steroids and intravenous immunoglobulin (IVIG) to reach the optimal platelet level. The aim of the study was to provide guidance on how to manage a patient with ITP throughout pregnancy