Introduction:
Idiopathic thrombocytopenic purpura (ITP) is a very uncommon autoimmune condition that causes the blood's platelets to be destroyed, resulting in isolated thrombocytopenia and a higher risk of bleeding [1]. ITP's precise cause is still unknown, hence the term "idiopathic," however, it is thought to be caused by immune-mediated mechanisms. While petechiae, purpura, and easy bruising are the typical mucocutaneous bleeding signs of ITP, there are cases when individuals display unique clinical characteristics that make diagnosis difficult and necessitate specialised therapeutic approaches [2].
In this case report, we outline the situation of a 45-year-old female patient who had ITP and showed unusual clinical symptoms. She came with a generalised petechial rash throughout the extremities, oral mucosa, conjunctivae, and sporadic ecchymoses, as opposed to the traditional mucocutaneous bleeding signs [3]. This unique presentation emphasises the clinical diversity of ITP and the significance of considering manifestations other than common bleeding symptoms. In order to diagnose ITP, other causes of thrombocytopenia, including viral infections, medicines, and underlying hematologic abnormalities, must be ruled out. Laboratory tests, such as complete blood counts, peripheral blood smear analyses, and autoimmune markers, must confirm the diagnosis of ITP. To rule out other potential aetiologies, additional studies may be necessary in instances with atypical clinical characteristics [4]. To boost platelet counts and lower the risk of bleeding, ITP is managed. Observation, corticosteroids, intravenous immunoglobulin (IVIG), and immunosuppressive medications are all possible forms of treatment. The severity of the thrombocytopenia, bleeding symptoms, and the patient's features all influence the therapy option [5].
This case report emphasises the difficulties in detecting and treating ITP with unusual clinical presentations and emphasises the value of an all-encompassing strategy and customised treatment plans. Understanding the various ITP presentations helps enhance patient management and outcomes in this complex autoimmune condition.
Case presentation:
A 45-year-old woman who had several petechiae and ecchymosis for one month came to our haematology clinic. Periodically, she would endure moderate gum bleeding and epistaxis. The patient denied having any recent infections, taking any drugs, or having a history of hematologic abnormalities. Upon physical examination, a petechial rash covering the conjunctivae, oral mucosa, and extremities was found as shown in Figure 1, in addition to sporadic ecchymoses. Organomegaly or lymphadenopathies were absent.