CYCLICAL THROMBOCYTOPENIA: A DIAGNOSTIC DILEMMA

Cyclical thrombocytopenia (CTP) is a rare hematological disorder that is defined by period fluctuations in platelet counts, leading to symptomatic thrombocytopenia. It is frequently misdiagnosed as immune thrombocytopenic purpura (ITP) and poses a unique diagnostic and therapeutic challenge to physicians. Its pathophysiology is still elusive, and its clinical course is unpredictable. We report the case of a 45-year-old female who presented with multiple episodes of mucocutaneous bleeding and thrombocytopenia and was initially managed as ITP, which proved to be ineffective. A review of her medical history was suggestive of recurrent episodes of symptomatic thrombocytopenia, and corresponding serial platelet monitoring showed cyclical platelet fluctuations, subsequently leading to a diagnosis of CTP. This case highlights the importance of recognizing CTPas a distinct clinical entity and including it in the differential diagnosis while working up a patient with thrombocytopenia. Further research is warranted to illustrate its pathogenesis, develop novel therapeutic options, and improve patient outcomes.