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Immune Thrombocytopenic Purpura as an Extraintestinal Manifestation in a Patient with Ulcerative Colitis

Immune thrombocytopenic purpura (ITP) is characterized by the presence of autoantibodies against platelet membrane antigens, leading to immune-mediated platelet destruction. ITP is considered as a rare extraintestinal manifestation (EIM) of ulcerative colitis (UC). This report aimed to describe a ra...

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Autores principales: de Medeiros Dutra, Renata, Almeida, Luciana Rocha, Sinkos, Camila, Muraro Bonini, Ana Clara, Saad-Hossne, Rogerio, Baima, Julio Pinheiro, Sassaki, Ligia Yukie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9035917/
https://www.ncbi.nlm.nih.gov/pubmed/35528763
http://dx.doi.org/10.1159/000522379
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author de Medeiros Dutra, Renata
Almeida, Luciana Rocha
Sinkos, Camila
Muraro Bonini, Ana Clara
Saad-Hossne, Rogerio
Baima, Julio Pinheiro
Sassaki, Ligia Yukie
author_facet de Medeiros Dutra, Renata
Almeida, Luciana Rocha
Sinkos, Camila
Muraro Bonini, Ana Clara
Saad-Hossne, Rogerio
Baima, Julio Pinheiro
Sassaki, Ligia Yukie
author_sort de Medeiros Dutra, Renata
collection PubMed
description Immune thrombocytopenic purpura (ITP) is characterized by the presence of autoantibodies against platelet membrane antigens, leading to immune-mediated platelet destruction. ITP is considered as a rare extraintestinal manifestation (EIM) of ulcerative colitis (UC). This report aimed to describe a rare case of UC associated with ITP and a review of the literature. A 49-year-old man was admitted to our hospital with severe acute colitis which was responsive to treatment (hydrocortisone 300 mg/day). The patient was discharged from the hospital with prednisone 60 mg/day and azathioprine 50 mg/day. During the follow-up, the dose of azathioprine was increased to 100 mg/day (1.3 mg/kg), while prednisone tapering was started. After 3 months, the patient presented with thrombocytopenia (30,000 platelets/µL) without improvement despite receiving the suspension of azathioprine; thus, a bone marrow aspirate was performed. The bone marrow analysis showed hyperplasia of the erythroid series, megaloblastosis, hyperplasia of megakaryocytes with mild dyspoiesis, and absence of cytotoxicity, a morphological finding consistent with ITP. The patient was treated with prednisone 1 mg/kg/day which resulted in partial improvement of the condition and his still being followed up as outpatient using mesalazine 3.2 g for UC and a platelet count of approximately 50,000/µL using eltrombopag. As reported, ITP is a rare EIM in patients with UC. Due to the risk of complications, such as bleeding, hematological changes in these patients should be considered. The disease should be suspected in the presence of thrombocytopenia, always excluding the side effects of medications in advance, especially immunosuppressants. The correct diagnosis of this rare manifestation and proper treatment are essential to control the condition, prevent complications, and improve the patient's prognosis.
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spelling pubmed-90359172022-05-06 Immune Thrombocytopenic Purpura as an Extraintestinal Manifestation in a Patient with Ulcerative Colitis de Medeiros Dutra, Renata Almeida, Luciana Rocha Sinkos, Camila Muraro Bonini, Ana Clara Saad-Hossne, Rogerio Baima, Julio Pinheiro Sassaki, Ligia Yukie Case Rep Gastroenterol Case and Review Immune thrombocytopenic purpura (ITP) is characterized by the presence of autoantibodies against platelet membrane antigens, leading to immune-mediated platelet destruction. ITP is considered as a rare extraintestinal manifestation (EIM) of ulcerative colitis (UC). This report aimed to describe a rare case of UC associated with ITP and a review of the literature. A 49-year-old man was admitted to our hospital with severe acute colitis which was responsive to treatment (hydrocortisone 300 mg/day). The patient was discharged from the hospital with prednisone 60 mg/day and azathioprine 50 mg/day. During the follow-up, the dose of azathioprine was increased to 100 mg/day (1.3 mg/kg), while prednisone tapering was started. After 3 months, the patient presented with thrombocytopenia (30,000 platelets/µL) without improvement despite receiving the suspension of azathioprine; thus, a bone marrow aspirate was performed. The bone marrow analysis showed hyperplasia of the erythroid series, megaloblastosis, hyperplasia of megakaryocytes with mild dyspoiesis, and absence of cytotoxicity, a morphological finding consistent with ITP. The patient was treated with prednisone 1 mg/kg/day which resulted in partial improvement of the condition and his still being followed up as outpatient using mesalazine 3.2 g for UC and a platelet count of approximately 50,000/µL using eltrombopag. As reported, ITP is a rare EIM in patients with UC. Due to the risk of complications, such as bleeding, hematological changes in these patients should be considered. The disease should be suspected in the presence of thrombocytopenia, always excluding the side effects of medications in advance, especially immunosuppressants. The correct diagnosis of this rare manifestation and proper treatment are essential to control the condition, prevent complications, and improve the patient's prognosis. S. Karger AG 2022-03-25 /pmc/articles/PMC9035917/ /pubmed/35528763 http://dx.doi.org/10.1159/000522379 Text en Copyright © 2022 by S. Karger AG, Basel https://creativecommons.org/licenses/by-nc/4.0/This article is licensed under the Creative Commons Attribution-NonCommercial-4.0 International License (CC BY-NC) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes requires written permission.
spellingShingle Case and Review
de Medeiros Dutra, Renata
Almeida, Luciana Rocha
Sinkos, Camila
Muraro Bonini, Ana Clara
Saad-Hossne, Rogerio
Baima, Julio Pinheiro
Sassaki, Ligia Yukie
Immune Thrombocytopenic Purpura as an Extraintestinal Manifestation in a Patient with Ulcerative Colitis
title Immune Thrombocytopenic Purpura as an Extraintestinal Manifestation in a Patient with Ulcerative Colitis
title_full Immune Thrombocytopenic Purpura as an Extraintestinal Manifestation in a Patient with Ulcerative Colitis
title_fullStr Immune Thrombocytopenic Purpura as an Extraintestinal Manifestation in a Patient with Ulcerative Colitis
title_full_unstemmed Immune Thrombocytopenic Purpura as an Extraintestinal Manifestation in a Patient with Ulcerative Colitis
title_short Immune Thrombocytopenic Purpura as an Extraintestinal Manifestation in a Patient with Ulcerative Colitis
title_sort immune thrombocytopenic purpura as an extraintestinal manifestation in a patient with ulcerative colitis
topic Case and Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9035917/
https://www.ncbi.nlm.nih.gov/pubmed/35528763
http://dx.doi.org/10.1159/000522379
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