Refractory Immune Thrombocytopenic Purpura with Abdominal Splenosis: A Complex Case

Immune thrombocytopenia (ITP) is an acquired thrombocytopenia resulting from immune-mediated platelet destruction via antiplatelet antibodies and T cells. Medical management of ITP includes corticosteroids and multiple other adjunct therapies, with splenectomy generally being reserved for severe, re...

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Main Authors: Joseph F. Mort, Danh T. Tran, Sean C. Dougherty, Robert Zielinski, Michael D. Williams, Kelly M. Davidson
Format: Article
Language:English
Published: Wiley 2023-01-01
Series:Case Reports in Hematology
Online Access:http://dx.doi.org/10.1155/2023/9714457
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author Joseph F. Mort
Danh T. Tran
Sean C. Dougherty
Robert Zielinski
Michael D. Williams
Kelly M. Davidson
author_facet Joseph F. Mort
Danh T. Tran
Sean C. Dougherty
Robert Zielinski
Michael D. Williams
Kelly M. Davidson
author_sort Joseph F. Mort
collection DOAJ
description Immune thrombocytopenia (ITP) is an acquired thrombocytopenia resulting from immune-mediated platelet destruction via antiplatelet antibodies and T cells. Medical management of ITP includes corticosteroids and multiple other adjunct therapies, with splenectomy generally being reserved for severe, refractory cases. In this clinical case report, we describe the evaluation of a 35-year-old male with a history of prior traumatic splenic injury who presented to the emergency department endorsing easy bruising and a petechial rash, ultimately found to have severe thrombocytopenia. The patient was diagnosed with primary ITP that proved to be refractory to a number of first- and second-line medical therapies. His course was complicated by the presence of abdominal splenosis discovered at the time of planned splenectomy and intra-abdominal hemorrhage requiring splenic artery embolization thereafter. To our knowledge, this is one of few published cases of ITP complicated by abdominal splenosis, highlighting the need to consider splenosis and the presence of accessory splenic tissue in cases of refractory ITP.
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spelling doaj-art-bfd68f09f96349d283ad02c64fe42e452025-08-20T03:05:17ZengWileyCase Reports in Hematology2090-65792023-01-01202310.1155/2023/9714457Refractory Immune Thrombocytopenic Purpura with Abdominal Splenosis: A Complex CaseJoseph F. Mort0Danh T. Tran1Sean C. Dougherty2Robert Zielinski3Michael D. Williams4Kelly M. Davidson5University of VirginiaUniversity of VirginiaUniversity of VirginiaUniversity of VirginiaUniversity of VirginiaUniversity of VirginiaImmune thrombocytopenia (ITP) is an acquired thrombocytopenia resulting from immune-mediated platelet destruction via antiplatelet antibodies and T cells. Medical management of ITP includes corticosteroids and multiple other adjunct therapies, with splenectomy generally being reserved for severe, refractory cases. In this clinical case report, we describe the evaluation of a 35-year-old male with a history of prior traumatic splenic injury who presented to the emergency department endorsing easy bruising and a petechial rash, ultimately found to have severe thrombocytopenia. The patient was diagnosed with primary ITP that proved to be refractory to a number of first- and second-line medical therapies. His course was complicated by the presence of abdominal splenosis discovered at the time of planned splenectomy and intra-abdominal hemorrhage requiring splenic artery embolization thereafter. To our knowledge, this is one of few published cases of ITP complicated by abdominal splenosis, highlighting the need to consider splenosis and the presence of accessory splenic tissue in cases of refractory ITP.http://dx.doi.org/10.1155/2023/9714457
spellingShingle Joseph F. Mort
Danh T. Tran
Sean C. Dougherty
Robert Zielinski
Michael D. Williams
Kelly M. Davidson
Refractory Immune Thrombocytopenic Purpura with Abdominal Splenosis: A Complex Case
Case Reports in Hematology
title Refractory Immune Thrombocytopenic Purpura with Abdominal Splenosis: A Complex Case
title_full Refractory Immune Thrombocytopenic Purpura with Abdominal Splenosis: A Complex Case
title_fullStr Refractory Immune Thrombocytopenic Purpura with Abdominal Splenosis: A Complex Case
title_full_unstemmed Refractory Immune Thrombocytopenic Purpura with Abdominal Splenosis: A Complex Case
title_short Refractory Immune Thrombocytopenic Purpura with Abdominal Splenosis: A Complex Case
title_sort refractory immune thrombocytopenic purpura with abdominal splenosis a complex case
url http://dx.doi.org/10.1155/2023/9714457
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