Gürkan Emel, Başlamişli Fikri, Güvenç Birol, Bozkurt Berna, Unsal Cağatay
Department of Hematology, Cukurova University Faculty of Medicine, Balcali, Adana, Turkey.
Am J Hematol. 2003 Sep;74(1):52-4. doi: 10.1002/ajh.10382.
Bacterial and protozoal infections can cause thrombocytopenia and may mimic idiopathic thrombocytopenic purpura (ITP). Brucella species and Toxoplasma are among the infectious agents with protean clinical manifestations which may induce immune thrombocytopenia. In rare cases, thrombocytopenia can be severe and may result bleeding into the skin and from mucosal sites. Prompt recognition of this complication and aggressive therapy are essential, since the mortality associated with bleeding into the central nervous system is high. We report two patients with complaints of severe epistaxis and thrombocytopenia associated with brucellosis and toxoplasmosis. Thrombocytopenic purpura in these cases responded well to the high-dose corticosteroid treatment with platelet recovery within 2-3 days. For cases with infection-induced immune thrombocytopenic purpura, short-term high-dose corticosteroids may be applied as an urgent therapy without worsening of the clinical condition.
细菌和原生动物感染可导致血小板减少，并可能酷似特发性血小板减少性紫癜（ITP）。布鲁氏菌属和弓形虫是具有多种临床表现的感染因子，可诱发免疫性血小板减少。在罕见情况下，血小板减少可能很严重，并可能导致皮肤和黏膜部位出血。及时识别这种并发症并积极治疗至关重要，因为中枢神经系统出血相关的死亡率很高。我们报告了两名因布鲁氏菌病和弓形虫病出现严重鼻出血和血小板减少症状的患者。这些病例中的血小板减少性紫癜对大剂量皮质类固醇治疗反应良好，血小板在2 - 3天内恢复。对于感染诱发的免疫性血小板减少性紫癜病例，短期大剂量皮质类固醇可作为紧急治疗应用，而不会使临床状况恶化。
