Chandra Subhash, Finn Sarah, Obah Eugene
Department of Internal Medicine, Greater Baltimore Medical Center, Baltimore, MD, USA.
J Community Hosp Intern Med Perspect. 2014 Apr 14;4(2). doi: 10.3402/jchimp.v4.23386. eCollection 2014.
Over 100 extraintestinal manifestations are reported in ulcerative colitis (UC). A commonly reported hematological manifestation is autoimmune hemolytic anemia. On rare occasions, immune thrombocytopenic purpura (ITP) has been reported with UC. The presence of thrombocytopenia can complicate the clinical scenario as the number of bloody bowel movements is an important indicator of disease activity in UC. A proposed theory for this association is antigenic mimicry between a platelet surface antigen and bacterial glycoprotein. We are reporting a case of UC and associated ITP managed successfully with anti-TNF therapy. We also performed a systemic review of case reports and a case series reporting this association.
据报道,溃疡性结肠炎(UC)有100多种肠外表现。一种常见的血液学表现是自身免疫性溶血性贫血。在极少数情况下,UC患者会出现免疫性血小板减少性紫癜(ITP)。血小板减少的存在会使临床情况复杂化,因为血性排便次数是UC疾病活动的一个重要指标。关于这种关联的一种假说认为是血小板表面抗原与细菌糖蛋白之间存在抗原模拟。我们报告了一例通过抗TNF治疗成功治愈的UC合并ITP病例。我们还对报道这种关联的病例报告和病例系列进行了系统综述。