Haematopoiesis

Biology

Gestation

Thrombopoietin

Melena

Stem cell

Romiplostim

Immunology

Genetics

Cyclophosphamide

Internal medicine

Chemotherapy

Medicine

Gastroenterology

Systemic lupus erythematosus

Disease

Rituximab

Antibody

Pregnancy

Intravenous Immunoglobulins

Lupus

We present a case of a pregnant woman at 27 weeks of gestation with systemic lupus erythematosus who developed severe thrombocytopenia presenting with melena, epistaxis, gum bleeding and frank hematuria. She was resistant to most treatment modalities, including steroids, intravenous immunoglobulins (IVIG), rituximab, IV cyclophosphamide and eltrombopag. She responded to romiplostim with normalization of her platelet count, which enabled her to be delivered safely at 34 weeks of gestation.

Successful treatment of severe thrombocytopenia with romiplostim in a pregnant patient with systemic lupus erythematosus