Tang Fajuan, Xiao Dongqiong, Chen Lin, Li Xihong, Qiao Lina
Department of Emergency, West China Second University Hospital, Sichuan University, Chengdu, 610041, Sichuan, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, 610041, China.
Thromb J. 2024 Apr 29;22(1):41. doi: 10.1186/s12959-024-00611-w.
Some causes of first-line treatment failure for ITP are often closely related to infections. But parasitic infections are rarely mentioned and easily overlooked. The case is the first to describe a boy with immune thrombocytopenia associated with blastocystis hominis.
The case involved a boy presenting with bleeding skin spots and ecchymosis and accompanied by intermittent epigastric pain and constipation. After a series of complete examinations, the platelet count was found to be decreased to 13 × 10/L and immune thrombocytopenia was diagnosed. After first-line treatment with gamma globulin and prednisolone, the thrombocytopenia remained unchanged. Blastocystis hominis was subsequently found in the patient's stool and then the treatment of metronidazole was provided. One week later, the patient's thrombocytopenia was completely relieved. He was followed up for six months and was found to have recovered well.
The screening for potential predisposing factors is very important for immune thrombocytopenia patients with poor response to first-line treatment, and the best treatment strategy should include the management of potential diseases.
免疫性血小板减少症（ITP）一线治疗失败的一些原因通常与感染密切相关。但寄生虫感染很少被提及且容易被忽视。该病例是首例描述一名与人类芽囊原虫相关的免疫性血小板减少症男孩的病例。
该病例为一名男孩，出现皮肤瘀点和瘀斑，并伴有间歇性上腹部疼痛和便秘。经过一系列全面检查，发现血小板计数降至13×10⁹/L，诊断为免疫性血小板减少症。在使用丙种球蛋白和泼尼松龙进行一线治疗后，血小板减少症未见改善。随后在患者粪便中发现了人类芽囊原虫，然后给予甲硝唑治疗。一周后，患者的血小板减少症完全缓解。对他进行了六个月的随访，发现恢复良好。
对于一线治疗反应不佳的免疫性血小板减少症患者，筛查潜在的诱发因素非常重要，最佳治疗策略应包括对潜在疾病的管理。
