We report a case of a 58-year-old man with recurrent unprovoked deep vein thrombosis (DVT) and severe immune thrombocytopenia (ITP) with a platelet count of 19 × 109/L. We further review studies reporting venous thromboembolism (VTE) in patients with severe ITP (≤ 35 × 109/L) and identified 14 patients highlighting VTE risk factors and management of these patients. The present case had several risk factors for VTE (previous DVT, obesity, heterozygosity for factor V Leiden mutation, and previous splenectomy). The patient was initially treated with low-molecular-weight heparin followed by long-term apixaban treatment. The literature review together with our case demonstrates that VTE in severe ITP (≤ 35 × 109/L) can occur in patients with VTE risk factors and antithrombotic management of these patients can be achieved without bleeding depending on severity of thrombocytopenia either by full or reduced dose of anticoagulation together with ITP therapy.

An ethical review is not required for this type of article. The patient is aware that his clinical details are used in this article. Written consent was given by the patient.

M.H.N. performed the literature review, interpreted the data, and wrote the first draft of the manuscript and approved the final manuscript.

M.V.B. planned the study, supervised for the recruitment of the subject, performed the literature review, interpreted the data, and supervised the writing of the manuscript, and approved the final manuscript.

The data supporting the findings of this study are available on request due to privacy/ethical restrictions.

Received: 17 April 2023

Accepted: 23 August 2023

Article published online:
31 October 2023

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