Sakuma Masayoshi, Takahashi Daigoro, Kamei Keitaro, Takayama Yuichi, Takahashi Takamasa, Aoyama Hiroki, Hosoi Takahiro, Maeda Atsuyuki
Department of Surgery, Ogaki Municipal Hospital, 4-86, Minaminokawa-cho, Ogaki city, Gifu, Japan.
J Surg Case Rep. 2024 Sep 26;2024(9):rjae607. doi: 10.1093/jscr/rjae607. eCollection 2024 Sep.
Immune thrombocytopenic purpura (ITP) is a rare autoimmune disorder. Although secondary ITP, caused by various underlying diseases, including some malignant tumors, has been reported, instances of ITP resolving after successful treatment of the underlying cause are uncommon and noteworthy. Herein, we present a case of a patient with perihilar cholangiocarcinoma (pCCA) and ITP who achieved drug-free remission of ITP following tumor resection. A 76-year-old man presented with pCCA complicated by ITP. Prednisolone treatment successfully managed his thrombocytopenia, allowing for a left hepatopancreatoduodenectomy. ITP relapse did not occur after discontinuation of prednisolone postoperatively. This case suggests that surgical resection of the underlying malignancy may induce remission of secondary ITP associated with pCCA.
免疫性血小板减少性紫癜(ITP)是一种罕见的自身免疫性疾病。虽然已经报道了由各种潜在疾病(包括一些恶性肿瘤)引起的继发性ITP,但在成功治疗潜在病因后ITP缓解的病例并不常见且值得关注。在此,我们报告一例肝门周围胆管癌(pCCA)合并ITP的患者,该患者在肿瘤切除后实现了ITP的无药缓解。一名76岁男性患者表现为pCCA合并ITP。泼尼松龙治疗成功控制了他的血小板减少症,从而得以进行左肝胰十二指肠切除术。术后停用泼尼松龙后未发生ITP复发。该病例表明,手术切除潜在恶性肿瘤可能会使与pCCA相关的继发性ITP缓解。