Missing Cells-A Rare Case of Persisting Thrombocytopenia in Pregnancy With Dengue and Role of Romiplostim in These Cases

OBJECTIVE: Dengue cases in pregnancy have high morbidity and mortality. More so if it leads to immune thrombocytopenic purpura which causes a drastic decrease in platelet, increasing chances of bleeding and mortality and pregnancy itself being a state of hemodynamic instability. CASE REPORT: Here, we present a case of dengue causing secondary immune thrombocytopenia. Managing these cases is challenging and need a multidisciplinary approach and should be done at a higher center. In previous reports, thrombocytopenia in such cases responded to steroids or IVIG. But in our case patient did not respond to either of them but to Romiplostim. There are only a few studies on the use of Romiplostim in dengue and dengue induced ITP and more study is required. CONCLUSION: Dengue induced persistent thrombocytopenia is rare but should always be kept in mind in managing these cases.