Authors
Jandir Mendonça Nicacio, Lucyo Flávio Bezerra Diniz, Andre Luis Magalhães Fernandes
Published in
Journal of Brown hospital medicine. Volume 5. Issue 3. Pages 162033. Epub Jul 01, 2026.
Abstract
Cyclic thrombocytopenia (CTP) is a rare hematologic disorder characterized by fluctuating platelet counts and is often misdiagnosed as immune thrombocytopenia. We present the case of a 51-year-old woman with a history of severe thrombocytopenia and mucocutane-ous bleeding since 2012, initially treated as immune thrombocytopenia with corticoster-oids, splenectomy, and azathioprine, without sustained response. Over time, she devel-oped pronounced cyclic fluctuations in platelet counts (<10,000/mm³ to >150,000/mm³) every 21 days. Treatment with eltrombopag resulted in deep venous thrombosis and a major pulmonary bleeding episode associated with anticoagulation. After secondary causes and bone marrow disorders were excluded, cyclic thrombocytopenia was diag-nosed. Rituximab (375 mg/m² weekly for four weeks) led to a significant reduction in platelet oscillations, with no further significant bleeding. This case highlights the diagnos-tic challenges of CTP, underscores the thrombotic risks of thrombopoietin receptor agonists, and supports rituximab as a potential treatment for refractory cases with high thrombo-hemorrhagic risk.
PMID:
42405365
Bibliographic data and abstract were imported from PubMed on 06 Jul 2026.
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