Ketema Worku, Taye Kefyalew, Tagesse Negash, Eifa Aberash
Department of Paediatrics and Child Health, Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia.
Department of Midwifery, Hawassa University Comprehensive Specialized Hospital, Hawassa, Ethiopia.
Int Med Case Rep J. 2022 Mar 5;15:85-90. doi: 10.2147/IMCRJ.S355892. eCollection 2022.
Isolated thrombocytopenia with normal levels of other cell lines in the absence of other reasons is referred to as "immune thrombocytopenic purpura" (ITP). Tuberculosis has been associated with a variety of hematologic abnormalities, although severe thrombocytopenia and tuberculosis presenting as immune thrombocytopenic purpura are extremely uncommon.
We discuss a case of an 11-year-old male adolescent who came with epistaxis and petechial rash lasting one day, as well as severe thrombocytopenia. Following the clinical diagnosis of ITP, the patient was started on prednisone, transfused with platelets, and later started on antituberculosis (ATT) after confirmation of tuberculosis. The patient had a satisfactory response during the course of treatment, and the platelet level was fully recovered after 6 months.
Tuberculosis (TB) should be recognized as a cause of immunological thrombocytopenia in tuberculosis-endemic areas. Our patient's platelet count improved after 1 week of ATT and 2 weeks of prednisolone, and it was entirely restored after 6 months of ATT treatment. Unfortunately, there are no clear guidelines for treating TB-related immune thrombocytopenia or determining the cause of TB-related immune thrombocytopenia. Tuberculosis-induced ITP resolves with the ATT, even though more investigation is warranted.
在没有其他原因的情况下,其他细胞系水平正常而孤立性血小板减少被称为“免疫性血小板减少性紫癜”(ITP)。结核病与多种血液学异常有关,尽管严重血小板减少和表现为免疫性血小板减少性紫癜的结核病极为罕见。
我们讨论一例11岁男性青少年病例,该患者因鼻出血和瘀点皮疹持续一天前来就诊,同时伴有严重血小板减少。在临床诊断为ITP后,患者开始使用泼尼松治疗,输注血小板,后来在确诊结核病后开始抗结核治疗(ATT)。患者在治疗过程中反应良好,6个月后血小板水平完全恢复。
在结核病流行地区,应认识到结核病是免疫性血小板减少的一个原因。我们的患者在接受1周的ATT和2周的泼尼松龙治疗后血小板计数有所改善,在接受6个月的ATT治疗后完全恢复。不幸的是,目前尚无治疗结核相关免疫性血小板减少或确定结核相关免疫性血小板减少病因的明确指南。尽管仍需更多研究,但结核病引起的ITP可通过ATT治愈。