# Refractory Thrombotic Thrombocytopenic Purpura in a Patient With Triple X Syndrome

## TL;DR

A patient with triple X syndrome developed a rare autoimmune condition that did not respond to standard treatments but improved with vincristine.

## Contribution

This is the first reported case in Brazil of triple X syndrome co-occurring with refractory thrombotic thrombocytopenic purpura.

## Key findings

- The patient's TTP was unresponsive to plasmapheresis and rituximab.
- Vincristine administration led to disease remission.
- This case highlights a rare genetic and autoimmune condition coexistence.

## Abstract

Clinical manifestations of triple X syndrome (karyotype 47, XXX) can include autoimmune diseases. We describe the occurrence of acquired thrombotic thrombocytopenic purpura (TTP), an autoimmune condition, refractory to plasmapheresis and rituximab in a patient with triple X syndrome who required vincristine administration for disease remission. To our knowledge, this rare coexistence is the first of its kind reported in Brazil.