Resolved Hypereosinophilic Syndrome and Immune Thrombocytopenic Purpura in Ulcerative Colitis Patients Post Colectomy: A Case Series and Literature Review

INTRODUCTION: Hypereosinophilic syndrome (HES) and immune thrombocytopenic purpura (ITP) have been reported to co-occur with ulcerative colitis (UC). However, the exact pathogenic mechanisms of their occurrence remain elusive. In this article, we aim to describe two cases of UC patients who developed refractory HES and ITP and elaborate on their potential pathogenesis. CASE STUDY: We report two middle-aged patients diagnosed with UC. The first patient developed HES that was refractory to conventional medical therapy of idiopathic HES, and the second developed refractory ITP that failed steroid and immunosuppressive therapy. Both conditions improved considerably following colectomy, suggesting they are of a reactive rather than idiopathic nature. CONCLUSION: In patients with UC and refractory comorbid HES or ITP, the reactive nature of these comorbidities should be taken into consideration, and colectomy, therefore, should be considered if clinically indicated.