Chandra Parijat, Kumawat Devesh, Kumar Vinod, Tewari Ruchir
All India Institute of Medical Sciences, Dr Rajendra Prasad Centre for Ophthalmic Sciences, New Delhi, Delhi, India.
BMJ Case Rep. 2017 Oct 4;2017:bcr-2017-221444. doi: 10.1136/bcr-2017-221444.
Although thrombocytopenia is known to be associated with pathogenesis of retinopathy of prematurity (ROP), immune thrombocytopenic purpura (ITP) is rare in infancy and not reported to occur with ROP. A preterm infant with aggressive posterior ROP developed bilateral massive subconjunctival haemorrhage after scleral indentation during screening. On evaluation, the infant was found to have severe ITP. Following intravenous transfusion of platelets and immunoglobulin, platelet counts improved and subconjunctival haemorrhage resolved over time. This case highlights the unusual presentation of ITP and also discusses the association of thrombocytopenia with ROP. Ophthalmologists should get prompt haematological work-up of such occurrences.
尽管已知血小板减少与早产儿视网膜病变（ROP）的发病机制有关，但免疫性血小板减少性紫癜（ITP）在婴儿期罕见，且未报道与ROP同时发生。一名患有侵袭性后部ROP的早产儿在筛查期间进行巩膜压陷后出现双侧大量结膜下出血。经评估，发现该婴儿患有严重ITP。在静脉输注血小板和免疫球蛋白后，血小板计数改善，结膜下出血随时间逐渐消退。本病例突出了ITP的不寻常表现，并讨论了血小板减少与ROP的关联。眼科医生应对此类情况及时进行血液学检查。
