SHM Converge Scientific Abstract ePoster Gallery-When Weight Loss Meets Platelet Loss: Immune Thrombocytopenic Purpura Following Compounded Tirzepatide

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This case report describes a rare episode of immune thrombocytopenic purpura (ITP) following use of compounded tirzepatide, a dual GIP/GLP-1 receptor agonist commonly used for weight loss and diabetes. A 41-year-old woman with a history of iron-deficiency anemia and menorrhagia developed spontaneous bruising, gingival bleeding, and petechiae after eight months of weekly compounded tirzepatide, which had been increased to 10 mg/week through a non-physician-supervised weight-loss program.<br /><br />On exam, she had widespread petechiae and ecchymoses, including oral mucosal involvement, without lymphadenopathy or splenomegaly. Laboratory testing showed severe isolated thrombocytopenia with a platelet count of 2,000/µL. Peripheral smear demonstrated large platelets and no schistocytes, and coagulation studies were normal. With no other obvious triggers and the temporal relationship to tirzepatide use, drug-induced ITP was suspected.<br /><br />The medication was stopped immediately, and she was treated with IVIG and corticosteroids, then transitioned to oral prednisone. Her platelet count improved rapidly, reaching 148,000/µL by day 4 and normalizing by day 5. Bleeding resolved, steroids were tapered over the next month, and she remained in remission six months later.<br /><br />The authors note that drug-induced ITP can occur weeks to months after exposure and may result from immune-mediated platelet destruction. While tirzepatide itself has not been commonly linked to hematologic toxicity, compounded formulations may carry added risk because of variability in preparation, excipients, or contaminants. The report emphasizes the need for caution, closer surveillance, and further research into the safety of compounded tirzepatide products.

Asset Subtitle

Zain Khan

Meta Tag

Author List Lucas Hopkins, Zain Khan

Category Clinical Vignettes

Concept Tirzepatide

Concept Immune Thrombocytopenia

Concept Thrombocytopenia

Concept Drug-Induced Immune Thrombocytopenia

Concept Discontinuation

Distinguished Non-Finalist

Presenter Organization Wellstar Kennestone Internal Medicine

Presenting Author Zain Khan

Track Adult

Keywords

immune thrombocytopenic purpura

ITP

compounded tirzepatide

dual GIP/GLP-1 receptor agonist

drug-induced thrombocytopenia

severe thrombocytopenia

petechiae

ecchymoses

IVIG treatment

corticosteroids

Tirzepatide

Immune Thrombocytopenia

Thrombocytopenia

Drug-Induced Immune Thrombocytopenia

Discontinuation