Adolescent with Transvaginal Bleeding: Rare Presentation of Immune Thrombocytopenic Purpura

Immune thrombocytopenic purpura (ITP) is a common pediatric disease characterized by a low circulating platelet count. A 12-year-old female presented to the Emergency Department with menorrhagia of 10 days. Her physical exam was remarkable for ecchymosis in the lower extremities with petechia in the ankles. Hemoglobin and Hematocrit were 7.7 g/dl and 23.4% with platelets of 10/mm³ and giant platelets seen on the smear. She was admitted in the inpatient unit and successfully treated. ITP is a diagnosis of exclusion and a complete workup should be performed to rule out other etiologies. The risk of serious bleeding remains small.