Notes

23 year old female case of ?ITP in 2017 initially received steroids that time and remained stable since then off treatment. Having menorrhagia since menarche ?cause (Now U/S shows dermoid cyst). Presented with complaints of heavy menstrual bleeding Weakness and rash. She gives Hx of fever and rash for the past 15 days now fever settled taken cipro and estrogen. Patient initial labs show Hb of 6 and plat of 6. She was started on methylpred pulse 1gm and along with transamine and was transfused 6 platelets (active bleeding) and 2 Packed red cells. Her rest of labs including viral profile and ANA is pending. She was also given an option for marrow__________________Her bleeding has since improved with only spotting now. She still requires 2 more doses of methylpred atleast, followed by oral pred +/- azathioprine and with daily monitoring of cbc for trend of platelets. Patient was counselled regarding the severity of disease but family wish to take her home. So LAMA.