Américas Oncologia e Hematologia, Departamento de Hematologia, São Paulo, SP, Brasil.
Hospital Samaritano Higienópolis, Departamento de Hematologia, São Paulo, SP, Brasil.
Rev Soc Bras Med Trop. 2023 Jul 24;56:e00722023. doi: 10.1590/0037-8682-0072-2023. eCollection 2023.
Extrapulmonary tuberculosis associated with immune thrombocytopenia (ITP) is extremely rare. A likely association between ITP and pulmonary and lymph node tuberculosis was reported in a 29-year-old male patient. His platelet count decreased to 4,000/µL. Chest tomography revealed mediastinal adenomegaly, lymph node clusters in the aorta, and consolidation in the left upper lung lobe. Immunoglobulin and methylprednisolone were administered intravenously. The histopathology of the left upper lung lobe confirmed tuberculosis. The rifampicin/isoniazid/pyrazinamide/ethambutol regimen was initiated, and the corticosteroids were tapered off. This case suggests an association of tuberculosis with ITP, since the platelet count effectively normalized after tuberculosis treatment.
肺外结核合并免疫性血小板减少症（ITP）极为罕见。曾有报道称，29 岁男性患者的 ITP 与肺及淋巴结结核可能相关。他的血小板计数降至 4,000/µL。胸部 CT 显示纵隔淋巴结肿大、主动脉旁淋巴结簇及左上肺叶实变。患者接受了静脉注射免疫球蛋白和甲基强的松龙治疗。左上肺叶的组织病理学检查证实为结核。开始采用利福平/异烟肼/吡嗪酰胺/乙胺丁醇方案治疗，同时逐渐减少皮质类固醇用量。本例提示结核与 ITP 之间存在关联，因为在进行结核治疗后，血小板计数有效恢复正常。
