Immune thrombocytopenia (ITP) is an autoimmune-mediated disease caused by antibody-mediated platelet destruction and impaired platelet production by megakaryocytes.[1] Standard treatments include glucocorticoids, immunoglobulin (IVIG), immunosuppressive agents, thrombopoietin (TPO)-receptor agonists (RAs), splenectomy, and anti-D immunoglobulin.[2,3] However, 20 to 30% of patients with ITP do not respond to any of these treatments.[4] Managing refractory ITP remains a significant challenge for clinicians. The gene discussed is THPO; the disease is autoimmune thrombocytopenic purpura.