Dear Editor, We report a case of steroid refractory human immune deficiency virus-related immune thrombocytopenic purpura (HIV-TP) successfully treated with single dose of intravenous Anti-Rh (Anti D). Although anti-retroviral treatment is the preferred first option in this situation, we treated him with steroids and, subsequently, with Anti D partly according to the patient’s wishes. He showed a durable response (nearly 2 years now) to a single dose of treatment. We propose that Anti D should be considered before anti