Bairagya Tapan Das, Das Sibes Kumar, Jana Pulak Kumar, Bhattacharya Somnath
Department of Tuberculosis and Respiratory diseases, North Bengal Medical College, Sushratanagar, Darjeeling, India.
J Glob Infect Dis. 2012 Jul;4(3):175-7. doi: 10.4103/0974-777X.100580.
Thrombocytopenic purpura as a manifestation of pulmonary tuberculosis is very rare. We report a case of 25-year-old female who presented with thrombocytopenia-induced purpuric spots and an abnormal chest X-ray. There was no hepatosplenomegaly while the bone marrow examination revealed normal maturation of myeloid and erythroid series with increased megakaryocytes. Acid fast bacilli were seen in the sputum microscopy. A diagnosis of sputum smear positive pulmonary tuberculosis along with immune thrombocytopenia was made. High dose intravenous immunoglobulin therapy along with antituberculous drugs corrected the thrombocytopenia and also cured pulmonary tuberculosis. This case report illustrates the causal association between immune thrombocytopenia and tuberculosis.
血小板减少性紫癜作为肺结核的一种表现非常罕见。我们报告一例25岁女性，她出现了血小板减少引起的紫癜斑点，胸部X光检查异常。无肝脾肿大，骨髓检查显示髓系和红系成熟正常，巨核细胞增多。痰涂片镜检可见抗酸杆菌。诊断为痰涂片阳性肺结核合并免疫性血小板减少症。大剂量静脉注射免疫球蛋白治疗联合抗结核药物纠正了血小板减少症，也治愈了肺结核。本病例报告说明了免疫性血小板减少症与结核病之间的因果关系。
