Scenario 4: A 14-year-old female is brought to the urgent care by her mother, who states that the girl has had an abnormal number of bruises and “funny looking red splotches” on her legs. These bruises were first noticed about 2 weeks ago and are not related to trauma. PMH not remarkable and she takes no medications. The mother does state the girl is recovering from a “bad case of mono” and was on bedrest at home for the past 3 weeks. The girl noticed that her gums were slightly bleeding when she brushed her teeth that morning.

Labs at urgent care demonstrated normal hgb and hct with normal WBC differential. Platelet count of 100,000/mm3 was the only abnormal finding. The staff also noticed that the venipuncture site oozed for a few minutes after pressure was released. The doctor at urgent care referred the patient and her mother to the ED for a complete work-up of the low platelet count, including a peripheral blood smear for suspected immune thrombocytopenia purpura.

In addition to answering the questions posted for this case, I would like you to explore the difference between TTP and ITP. Also I would like you to explore medical treatments and potential surgical treatments for ITP. It is particularly relevant given we have seen some ITP with mRNA vaccines (rare) and also thrombocytopenia with the J&J vaccine. Please refer to the other questions you also need to answer that are in BB. Thank you.