Abstract:
Immune thrombocytopenic purpura (ITP) is an
immune mediated bleeding disorder, usually has a
relatively benign clinical course. Deep seated
bleeding like intracranial haemorrhage or
haemoperitonium or massive haemorrhage requiring
transfusion or other intervention are rare in ITP,
unless platelet count are extremely low or other
complicating conditions coexist. Here are two case
reports of ITP presenting in uncommon and
devastating manners. The 1st one is of a 21- yearold
married nulliparaous lady with ITP
complicating her undiagnosed ovarian hyperstimulation
syndrome leading to haemoperitonium (ruptured
ovarian cyst), post operative alveolar haemorrhage
resulting in ARDS and later on DVT of right leg
on her 9th POD. She was managed by multi
discipline team. A new consequence of her disease
one after another was striking and made her
management more challenging. Ultimately the
lady recovered and was discharged with advice
which was not less than a miracle. The 2nd case is
of a 50- year- old elderly lady who had a
hemorrhagic stroke as a presenting feature of ITP.
Though ITP is not an uncommon disease but in
these cases its presentation, consequences and
severity was unusual and making its management
very much challenging.
Key words: ITP, ovarian hyperstimulation syndrome,
haemorrhage, Stroke