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溃疡性结肠炎合并血小板增多症:病例报告及文献复习。

Ulcerative colitis and thrombocytosis: Case report and literature review.

机构信息

Department of Clinical Medicine, Jining Medical University, Jining, Shandong, P.R. China.

Department of Gastroenterology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, Shandong, P.R. China.

出版信息

Medicine (Baltimore). 2023 May 19;102(20):e33784. doi: 10.1097/MD.0000000000033784.

Abstract

RATIONALE

Ulcerative colitis (UC) is an autoimmune disease of unknown etiology, sometimes associated with anemia and thrombocytosis. Platelets (PLTs) play a role in amplifying inflammatory and immune responses in chronic inflammation. This study discusses the diagnosis and treatment of a case of UC combined with secondary thrombocytosis and reviews the relevant literature. We report an interaction between thrombocytosis and UC to raise clinicians' awareness of this condition.

PATIENT CONCERNS

In the current report, we discuss the case of a 30-year-old female patient who presented with frequent diarrhea and thrombocytosis.

DIAGNOSIS

Severe UC combined with intestinal infection was diagnosed based on colonoscopy and intestinal biopsy. The patient had a PLT count >450 × 109/L and was diagnosed with reactive thrombocytosis.

INTERVENTIONS AND OUTCOMES

The patient was discharged from the hospital in remission after receiving vedolizumab and anticoagulant treatment.

LESSONS

In patients with severe UC with thrombocytosis, clinicians should pay attention to PLTs promoting inflammatory progression, as well as screening for venous thromboembolism risk and prophylactic anti-venous thromboembolism therapy at the time of dosing to avoid adverse effects.

摘要

背景

溃疡性结肠炎(UC)是一种病因不明的自身免疫性疾病,有时与贫血和血小板增多症有关。血小板(PLT)在慢性炎症中放大炎症和免疫反应中起作用。本研究讨论了一例 UC 合并继发血小板增多症的诊断和治疗,并复习了相关文献。我们报告了血小板增多症与 UC 之间的相互作用,以提高临床医生对这种情况的认识。

病例介绍

本报告讨论了一位 30 岁女性患者的病例,该患者经常腹泻和血小板增多。

诊断

根据结肠镜检查和肠活检,诊断为严重 UC 合并肠道感染。患者的血小板计数>450×109/L,诊断为反应性血小板增多症。

干预措施和结果

患者接受维得利珠单抗和抗凝治疗后缓解出院。

结论

在伴有血小板增多症的严重 UC 患者中,临床医生应注意血小板促进炎症进展,并在给药时筛查静脉血栓栓塞风险和预防性抗静脉血栓栓塞治疗,以避免不良反应。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a733/10194520/73fdf3c57ffc/medi-102-e33784-g001.jpg

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