Severe Menorrhagia and Thrombocytopenia in a Patient with Pseudohypoparathyroidism

A 15-year-old female with a history of hypothyroidism presented with severe anemia and thrombocytopenia in the setting of prolonged menses. After further evaluation, she was diagnosed with pseudohypoparathyroidism Ia (PHPIa). Her symptoms improved after starting medications and receiving a platelet transfusion, but a few weeks later she returned with complaints of bleeding and dizziness and was found to be thrombocytopenic once again. Her platelet counts improved after administration of intravenous immunoglobulin (IVIG), leading us to believe she has a combined immune mediated platelet destruction in addition to platelet dysfunction associated with her PHPIa.