Yingchoncharoen Pitchaporn, Abdelnabi Mahmoud, Thongpiya Jerapas, Hoffman Alexandra, Tariq Hira, Mittal Neha
Department of Internal Medicine Texas Tech University Health Sciences Center Lubbock Texas USA.
Shalamar Institute of Health Sciences Lahore Pakistan.
Clin Case Rep. 2023 Sep 27;11(10):e7960. doi: 10.1002/ccr3.7960. eCollection 2023 Oct.
Immune thrombocytopenic purpura (ITP) is very challenging to diagnose with concurrent comorbidities affecting platelet count including PAH and autoimmune thyroid disease. ITP resolution can be achieved with tailored treatment of the underlying conditions to avoid adverse events.
Immune thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by a platelet count of <100 × 10/L in the absence of other causes of thrombocytopenia. It is classified as primary or idiopathic and secondary due to various coexisting conditions, including autoimmune thyroid diseases. It is especially challenging when the patient has comorbidities that affect platelet count easily, leading to anchoring bias. The first-line treatment of ITP is corticosteroids, and it is also recommended to treat the primary causes of secondary ITP. Here, the authors report a case of secondary ITP in a patient with a recent diagnosis of Grave's disease and a history of idiopathic pulmonary hypertension with baseline chronic thrombocytopenia, possible mechanisms, and treatment strategies with a multidisciplinary approach.
免疫性血小板减少性紫癜（ITP）在伴有影响血小板计数的合并症（包括肺动脉高压和自身免疫性甲状腺疾病）时，诊断极具挑战性。通过对基础疾病进行针对性治疗以避免不良事件，可实现ITP的缓解。
免疫性血小板减少性紫癜（ITP）是一种自身免疫性疾病，其特征为在无其他血小板减少原因的情况下，血小板计数<100×10⁹/L。它被分为原发性或特发性以及由各种并存疾病（包括自身免疫性甲状腺疾病）导致的继发性。当患者伴有易影响血小板计数的合并症时，诊断尤其具有挑战性，这会导致锚定偏差。ITP的一线治疗是使用糖皮质激素，同时也建议治疗继发性ITP的原发病因。在此，作者报告了一例近期诊断为格雷夫斯病且有特发性肺动脉高压病史并伴有基线慢性血小板减少的继发性ITP患者病例、可能的机制以及采用多学科方法的治疗策略。
