Abstract
We report a case of a 58-year-old man with recurrent unprovoked deep vein thrombosis
(DVT) and severe immune thrombocytopenia (ITP) with a platelet count of 19 × 109/L. We further review studies reporting venous thromboembolism (VTE) in patients with
severe ITP (≤ 35 × 109/L) and identified 14 patients highlighting VTE risk factors and management of these
patients. The present case had several risk factors for VTE (previous DVT, obesity,
heterozygosity for factor V Leiden mutation, and previous splenectomy). The patient
was initially treated with low-molecular-weight heparin followed by long-term apixaban
treatment. The literature review together with our case demonstrates that VTE in severe
ITP (≤ 35 × 109/L) can occur in patients with VTE risk factors and antithrombotic management of these
patients can be achieved without bleeding depending on severity of thrombocytopenia
either by full or reduced dose of anticoagulation together with ITP therapy.
Keywords
immune thrombocytopenia - venous thromboembolism - thrombotic disorder
