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周期性血小板减少症:复发性血小板减少症的罕见病因。

Cyclic Thrombocytopenia: A Rare Cause of Recurrent Thrombocytopenia.

作者信息

Oyenuga Mosunmoluwa, Onyechi Afoma, Sartaj Sara, Patel Rushin, Sinha Jyotsana

机构信息

Internal Medicine, SSM (Sisters of St. Mary) Health St. Mary's Hospital, St. Louis, USA.

Hematology and Medical Oncology, SSM (Sisters of St. Mary) Health St. Mary's Hospital, St. Louis, USA.

出版信息

Cureus. 2022 Feb 23;14(2):e22525. doi: 10.7759/cureus.22525. eCollection 2022 Feb.

Abstract

Cyclic thrombocytopenia (CTP) is a very rare hematological disorder that is characterized by periodic fluctuations in platelet counts. Diagnosis is generally delayed due to its similarity with immune thrombocytopenia (ITP). The pathophysiology is unknown and there are currently no guidelines for management. Many patients are usually treated for ITP initially prior to diagnosis. We describe a 67-year-old female with a history of multiple episodes of transient thrombocytopenia who presented to the hospital with another episode of thrombocytopenia. Her workup including HIV, hepatitis screening, vitamin B12, and folate was negative. She received a unit of platelet transfusion and was later observed in the hospital. Further review of her chart showed similar episodes in the past with spontaneous improvement. She was diagnosed with CTP. Her platelet count improved remarkably prior to discharge. In patients with recurrent fluctuation in their platelet count, CTP should be one of the differentials as this might prevent further unnecessary therapies.

摘要

周期性血小板减少症(CTP)是一种非常罕见的血液系统疾病,其特征是血小板计数呈周期性波动。由于其与免疫性血小板减少症(ITP)相似,诊断通常会延迟。其病理生理学尚不清楚,目前也没有管理指南。许多患者在诊断之前通常最初会按照ITP进行治疗。我们描述了一位67岁的女性,她有多次短暂性血小板减少发作史,此次因再次发作血小板减少症而入院。她的检查包括艾滋病毒、肝炎筛查、维生素B12和叶酸检测均为阴性。她接受了一个单位的血小板输注,随后在医院接受观察。进一步查阅她的病历发现过去有类似发作且可自发改善。她被诊断为CTP。出院前她的血小板计数显著改善。对于血小板计数反复波动的患者,CTP应作为鉴别诊断之一,因为这可能避免进一步不必要的治疗。

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本文引用的文献

1
How I manage cyclic thrombocytopenia.我是如何管理周期性血小板减少症的。
Blood. 2021 Jan 14;137(2):178-184. doi: 10.1182/blood.2020008218.
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Origins of oscillation patterns in cyclical thrombocytopenia.周期性血小板减少症中振荡模式的起源。
J Theor Biol. 2019 Feb 7;462:432-445. doi: 10.1016/j.jtbi.2018.11.024. Epub 2018 Nov 27.
5
Idiopathic cyclic thrombocytopenia.特发性周期性血小板减少症
Blood Rev. 2005 Jan;19(1):53-9. doi: 10.1016/j.blre.2004.05.001.
6
Clonal T cell-mediated cyclic thrombocytopenia.克隆性T细胞介导的周期性血小板减少症。
Br J Haematol. 2002 Dec;119(4):1059-61. doi: 10.1046/j.1365-2141.2002.03951.x.
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Br J Haematol. 1993 Dec;85(4):718-22. doi: 10.1111/j.1365-2141.1993.tb03214.x.
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Br J Haematol. 1989 Apr;71(4):519-24. doi: 10.1111/j.1365-2141.1989.tb06312.x.
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