First born girl child of the healthy young couple. She was normal and healthy until four and half years of age when she developed spontaneous skin and mucosal bleeds. She was diagnosed from another hospital as a case of ITP after clinical examination and bone marrow studies and was put on oral prednisolone 2 mg /kg for three weeks. She had a good response. While the dose of steroids was tapered, platelet count decreased and bleeding manifestations restarted. Tab mycophenolate mofetil was started daily 250 mg for two months and later tacrolimus (dose and duration) both with low dose steroids.
As the condition remained same, she was referred to us. There is no past history of medications, or significant medical illness. She is immunized up to date. No family history of an excessive bleeding tendency in the family for three generations. Analysis of such a case. Few points for…
