# Immune Thrombocytopenia in a 94-Year-Old Woman: Challenges in Diagnosis and Management of an Uncommon Presentation in the Elderly

## TL;DR

An elderly woman with immune thrombocytopenia faced diagnostic and treatment challenges, showing the need for tailored care in older patients.

## Contribution

Presents a rare case of ITP in a 94-year-old, emphasizing individualized treatment in elderly patients.

## Key findings

- The patient had a very low platelet count, diagnosed as immune thrombocytopenia.
- Treatment with dexamethasone, platelet transfusion, and IVIG led to complications.
- The case underscores the need for careful management of ITP in the elderly.

## Abstract

We describe a unique case of a 94-year-old woman who presented to the emergency department with a large hematoma on her left lateral thigh following a fall. Laboratory workup revealed a platelet count of 10,000/μL, and incidentally, just a week prior to her presentation in the emergency department, her platelet count was 26,000/μL. After consultation with hematology/oncology, a diagnosis of immune thrombocytopenia (ITP) was established, and she was given 40 mg dexamethasone, transfused with one unit of platelets, and initiated on intravenous immunoglobulin (IVIG). She returned to the emergency department a week later due to severe fatigue and transient loss of consciousness following IVIG administration. This case highlights the complexities of diagnosing and managing ITP in elderly patients, emphasizing the need for individualized treatment strategies to balance efficacy and safety.