Tsuji Takahiro, Mochinaga Hiromi, Yamasaki Hiroshi, Tsuda Hiroyuki
Department of Hematology and Oncology, Kumamoto City Hospital.
Rinsho Ketsueki. 2016 Jul;57(7):877-80. doi: 10.11406/rinketsu.57.877.
An 83-year-old woman was admitted to our hospital with a severe headache and purpura. She had previously been diagnosed with idiopathic thrombocytopenia purpura (ITP) and achieved complete remission with steroid therapy. Steroid therapy had been completed one week prior to the current admission. The recurrence of severe thrombocytopenia (<1.0×10(4) platelets/μl) was detected and a CT scan revealed pituitary hemorrhage without pituitary adenoma. She received steroid therapy combined with intravenous immunoglobulin, which resulted in the amelioration of ITP and improvements in the pituitary hemorrhage. Intracranial hemorrhage, which is the most serious bleeding manifestation in ITP, is relatively uncommon. Pituitary apoplexy in ITP is extremely rare.
一名83岁女性因严重头痛和紫癜入住我院。她此前被诊断为特发性血小板减少性紫癜（ITP），并通过类固醇治疗实现了完全缓解。类固醇治疗在本次入院前一周已结束。检测到严重血小板减少症复发（血小板<1.0×10⁴/μl），CT扫描显示垂体出血但无垂体腺瘤。她接受了类固醇治疗联合静脉注射免疫球蛋白，这使得ITP症状改善，垂体出血情况也有所好转。颅内出血是ITP中最严重的出血表现，相对少见。ITP合并垂体卒中极为罕见。
