A Case of Chronic Thrombocytopenia in a 17-Year-Old Female

Roger Riley, MD, PhD; Asad Khan, MD; Shella Pai, MS, SH(ASCP); Laura Warmke, MD; Marcus Winkler, MD; William Gunning, PhD


Lab Med. 2019;50(4):406-420. 

In This Article


The patient was a 17-year-old Asian adolescent girl with a past medical history of chronic thrombocytopenia, which originally had been identified by routine laboratory testing when she was 5 years old. Her initial symptoms consisted of persistent fevers and easy bruising. The numerical value of her platelet (PLT) count at that time could not be obtained. Treatment included a corticosteroid injection, which temporarily improved her PLT count, followed by an unknown oral medication, which she later discontinued. A working diagnosis of immune thrombocytopenic purpura (ITP) was rendered at the time of initial presentation.

The patient presented for care at our institution reporting gingival bleeding when brushing her teeth, bruising, menorrhagia with heavy menstrual flow lasting 7 days, chronic fatigue, and persistent leg and knee pain. She did not report epistaxis or other bleeding symptoms. Her family history was negative for any bleeding or other congenital disorders, although her parents were first cousins. The physical examination findings were within normal limits except for a few small bruises on her lower extremities.