REFRACTORY IMMUNE THROMBOCYTOPENIA WITH ANTIPHOSPHOLIPID ANTIBODIES

This case report details a 28-year-old female with refractory immune thrombocytopenia (ITP) and antiphospholipid antibodies (aPL). Initial management with corticosteroids, IVIG(intravenous immunoglobulin), and thrombopoietin receptor agonists (TPO-RAs) failed to sustain adequate platelet counts. The patient later suffered a subarachnoid haemorrhage and suspected adrenal thrombosis, complicating her condition.This report highlights the challenges of managing refractory ITP with aPL, emphasizing the need for individualized therapeutic strategies and vigilant monitoring to balance thrombosis and bleeding risks. Long-term immunosuppression with azathioprine stabilized her platelet count,providing a viable management approach for similar complex cases.