In the present report, we present a case with chronic HCV infection in which autoimmune thrombocytopenia developed at week 7 of PEG-IFN alpha 2b plus ribavirin therapy. The patient subsequently received ursodeoxycholic acid (UDCA) treatment. [ncbi.nlm.nih.gov]

Patients with chronic autoimmune thrombocytopenia typically present with petechiae and mucosa bleeding. Symptoms may be present for months, or some patients may experience more acute manifestations. [asmscience.org]

• Anemia

  In this case report, a 29-year-old woman with pernicious anemia and autoimmune thrombocytopenia who developed gastric carcinoid tumors of the gastric body is described. [ncbi.nlm.nih.gov]

  Nine patients with pediatric systemic lupus erythematosus were included in the study: 5 had autoimmune thrombocytopenia, 3 had autoimmune hemolytic anemia, and 1 had both. [pediatrics.aappublications.org]

• Lymphadenopathy

  We initially diagnosed them as having angioimmunoblastic lymphadenopathy with dysproteinemia (AILD). [ncbi.nlm.nih.gov]

  C 2, 21 Patients with myelodysplastic syndrome usually will present with anemia and lymphoma with lymphadenopathy. [aafp.org]

  • The presence of abnormal findings such as hepatosplenomegaly, bone or joint pain, or remarkable lymphadenopathy suggests other diagnoses 1/25/2015 Idiopathic Thrombocytopenic Purpura Prof.Dr. Saad S Al Ani Khorfakkan Hospital 18 19. [slideshare.net]

• Inflammation

  Inflamm Bowel Dis, 15 (2009), pp. 63-87 [3] L. Higuchi, S. Joffe, E. Neufeld, S. Weisdorf, J. Rosh, S. Murch, et al. Inflammatory bowel disease associated with immune thrombocytopenic purpura in children. [analesdepediatria.org]

  Inflamm Bowel Dis 10 (5): 698–700 PubMed CrossRef Google Scholar McMinn JR Jr, Cohen S, Moore J, Lilly S, Parkhurst J, Tarantino MD, Terrell DR, George JN (2003) Complete recovery from refractory immune thrombocytopenic purpura in three patients treated [link.springer.com]

  […] intravascular coagulation is responsible for a further 10–15% of cases, nearly always in babies who are very ill, particularly in association with perinatal asphyxia and infection. 14, 15, 17 Thrombosis or platelet activation/immobilisation at sites of inflammation—for [fn.bmj.com]

• Fever

  Other travel-associated infections, such as typhoid fever, can cause thrombocytopenia. 32 Ehrlichiosis, Rocky Mountain spotted fever, and Lyme disease are common tick-borne illnesses that can cause transient thrombocytopenia. 33 LIVER DISEASE Chronic [aafp.org]

  […] known as WinRho®): temporarily stops the spleen from destroying platelets child must have Rh-positive blood and must still have their spleen in order for this medication to be effective given intravenously temporary side effects include: mild anemia, fever [danafarberbostonchildrens.org]

  The side effects include: Nausea and vomiting Headaches Fever and chills Surgery. If you have ITP and other treatments haven't raised your platelet levels enough, you may benefit from an operation to remove your spleen. [webmd.com]

  There are other associated physical signs and symptoms in these disorders, such as: HTN and proteinuria in pre-eclampsia, right upper quadrant pain (RUQ) and abnormal LFTS in HELLP and acute fatty liver of pregnancy (AFLP), and fever, neurologic changes [cancertherapyadvisor.com]

• Hodgkin Lymphoma

  Splenectomy is effective in splenic marginal zone lymphoma. Autoimmune thrombocytopenia in patients with non-Hodgkin's lymphomas is potentially life-threatening and difficult to treat. [Indexed for MEDLINE] Free full text [ncbi.nlm.nih.gov]

  Treatment of autoimmune thrombocythemia in non-Hodgkin’s lymphoma. [haematologica.org]

• Easy Bruising

  A decrease in platelets can result in easy bruising, bleeding gums, and internal bleeding. ITP may be acute and resolve in less than 6 months, or chronic and last longer than 6 months. [hopkinsmedicine.org]

  The low platelet count causes easy bruising and bleeding, which may be seen as purple areas in the skin, mucous membranes, and outer linings of organs. [icd10data.com]

  A hereditary cause is suspected if there is a lifelong history of easy bruising; bleeding after tooth extractions, surgery, childbirth, or circumcision; or heavy menstruation. [merckmanuals.com]

  A decrease in platelets can result in easy bruising, bleeding gums and internal bleeding. "Idiopathic" means the cause is unknown. "Thrombocytopenia" means a decreased number of platelets in the blood. [chop.edu]

• Diarrhea

  Hemolytic uremic syndrome is thrombotic thrombocytopenic purpura found in children presenting with acute renal failure, bloody diarrhea, and/or abdominal pain. [aafp.org]

  […] abnormality with decreased levels of ADAMS TS 13 in congenital TTP (Upshaw-Shülman syndrome), abnormal complement regulatory proteins such as factor H, factor I, or membrane cofactor protein, either from mutations or autoantibodies, in congenital or acquired diarrhea-associated [cancertherapyadvisor.com]

• Arthritis

  Arch dermatol 117: 109-110. ], rheumatoid arthritis [ 8 8. Spigel GT, Winkelmann RK (1978) Cicatricial pemphigoid and rheumatoid arthritis. Arch Dermatol 114: 415-417. ], or mixed connectivitis [ 9 9. [peertechz.com]

  By investigating 38 rheumatoid arthritis (RA) patients on gold therapy, 10 with profound thrombocytopenia and 28 nonthrombocytopenic controls, we showed that in all 10 patients with thrombocytopenia, the platelet autoantibodies preferentially targeted [ncbi.nlm.nih.gov]

  Kling A, Rantapää-Dahlqvist S, Stenlund H, Mjörndal T: Decreased density of serotonin 5-HT2A receptors in rheumatoid arthritis. Ann Rheum Dis 2006;65:816-819. [karger.com]

  The risk appears to be higher in people who also have diseases such as rheumatoid arthritis, lupus and antiphospholipid syndrome. Complications A rare complication of immune thrombocytopenia is bleeding into the brain, which can be fatal. [mayoclinic.org]

  We also found other AD of the lupus-associated cluster such as Sjogren syndrome, autoimmune hemolytic anemia, rheumatoid arthritis and autoimmune hepatitis. [scirp.org]

• Osteoporosis

  The long-term use of corticosteroids can cause serious side effects, including: osteoporosis cataracts a loss of muscle mass an increased risk of infection diabetes Surgery to remove the spleen permanently increases your risk of bacterial infections and [healthline.com]

  Glucocorticoid-Induced Osteoporosis Intervention Study Group. [link.springer.com]

  Osteoporosis 1/25/2015 Idiopathic Thrombocytopenic Purpura Prof.Dr. Saad S Al Ani Khorfakkan Hospital 31 32. Treatment(Cont.) Intracranial hemorrhage Multiple modalities should be used, including: 1. Platelet transfusion 2. IVIG 3. [slideshare.net]

  […] steroid is gradually reduced while the possibility of relapse is monitored. 60–90 percent will experience a relapse during dose reduction or cessation. [9] [13] Long-term steroids are avoided if possible because of potential side-effects that include osteoporosis [en.wikipedia.org]

• Petechiae

  Patients with chronic autoimmune thrombocytopenia typically present with petechiae and mucosa bleeding. Symptoms may be present for months, or some patients may experience more acute manifestations. [asmscience.org]

  People may have tiny purple spots on their skin (petechiae) and bleed easily. Diagnosis is with blood tests to measure the number of platelets. Corticosteroids or other drugs are given to block the destruction of platelets. [msdmanuals.com]

  CASE REPORT: A 70-year-old woman was admitted with rectal bleeding accompanied by widespread petechiae, bruising, tongue and buccal mucosa bleeding, and epistaxes and proved refractory to HLA- and HPA-matched PLTs. [ncbi.nlm.nih.gov]

• Eczema

  Veien NK (2010): Bullous pemphigoid masquerading as recurrent vesicular hand eczema. Acta Derm Venereol 90: 4–5., 10 10. Malik M, Gürcan HM & Ahmed AR (2010): Coexistence of mucous membrane pemphigoid and connective-tissue disease. [peertechz.com]

• Epistaxis

  Treatment-related complications included transient hemorrhagic cystitis (1 patient), vaginal bleeding (2 patients), gastrointestinal bleeding (1 patient), epistaxis (1 patient), and antibiotic-responsive febrile neutropenia (all patients). [ncbi.nlm.nih.gov]

  In March 2003 the patient received high doses IVIg but during that treatment, aggravation of the haemorrhagic diathesis with epistaxis, menorrhea and secondary anaemia (Hb 8.2 g/dl) was observed. [springerlink.com]

  Severe: – Bleeding episodes—menorrhagia, epistaxis, melena—requiring transfusion or hospitalization - Symptoms interfering seriously with the quality of life 1/25/2015 Idiopathic Thrombocytopenic Purpura Prof.Dr. [slideshare.net]

  In the early stages of pregnancy there is generally no need to treat ITP unless the platelet count drops below 10,000-20,000/ul, or there is associated minor bleeding such as epistaxis and bruising. [cancertherapyadvisor.com]

  Therefore, our goal is to ameliorate the petechiae and nosebleeds (epistaxis) and not necessarily get one’s hemostatic platelet count up to 100,000. [hopkinsarthritis.org]

• Hematuria

  Symptoms and Signs Although often asymptomatic and identified only by a low platelet count on a routine assay, when present the symptoms and signs of immune thrombocytopenia are Petechiae Purpura Mucosal bleeding Gross GI bleeding and hematuria are less [merckmanuals.com]

  […] and Signs of ITP Although often asymptomatic and identified only by a low platelet count on a routine assay, when present the symptoms and signs of immune thrombocytopenia are Petechiae Purpura Mucosal bleeding Gross gastrointestinal (GI) bleeding and hematuria [msdmanuals.com]

• Guillain-Barré Syndrome

  Nevertheless, specific publications about the association of ITP and Hashimoto thyroiditis are scarce and they are generally case reports including additional associated AD, such as Guillain-Barré syndrome [21] or rheumatoid arthritis [22]. [scirp.org]

[…] future reference, as corticosteroids can change marrow morphology Biopsy is performed before splenectomy to evaluate for possible hypoplasia or fibrosis Unresponsiveness to standard treatment after 6 months is an indication for bone marrow aspiration See Workup [emedicine.medscape.com]

• Neutropenia

  D70.0 Congenital agranulocytosis D70.1 Agranulocytosis secondary to cancer chemotherapy D70.2 Other drug-induced agranulocytosis D70.3 Neutropenia due to infection D70.4 Cyclic neutropenia D70.8 Other neutropenia Reimbursement claims with a date of service [icd10data.com]

  Two cases of autoimmune neutropenia and thrombocytopenia occurring in two adult brothers are reported here. One patient showed prompt recovery of white cells with steroids but needed IV IgG+ splenectomy for durable platelet recovery. [ncbi.nlm.nih.gov]

• Leukopenia

  Immune thrombocytopenia (ITP) is a bleeding disorder usually without anemia or leukopenia. Typically, it is chronic in adults, but it is usually acute and self-limited in children. [msdmanuals.com]

  Patients with unexplained abnormalities in the CBC (such as leukocytosis, leukopenia, or anemia) in addition to thrombocytopenia may require bone marrow aspiration/biopsy. [cancertherapyadvisor.com]

  Evans R, Duane R: Acquired hemolytic anemia; the relation of erythrocyte antibody production to activity of the disease; the significance of thrombocytopenia and leukopenia. Blood 1949;4:1196-1213. [karger.com]

  […] of Haematology, 61, 339-348. http://dx.doi.org/10.1111/j.1365-2141.1985.tb02834.x [ 41 ] Evans, R.S. and Duane, R.T. (1949) Acquired Hemolytic Anemia: Relation of Erythrocyte Antibody to Activity of the Disease, Significance of Thrombocytopenia and Leukopenia [scirp.org]

• Decreased Platelet Count

  Additional laboratory evaluation should be performed as clinically indicated, and a trial of discontinuing agents known to decrease platelet counts is recommended. [aafp.org]

  The resulting shortened life span of platelets in the circulation, together with incomplete compensation by increased platelet production by bone marrow megakaryocytes, results in a decreased platelet count. [emedicine.medscape.com]

• Leukocytosis

  Patients with unexplained abnormalities in the CBC (such as leukocytosis, leukopenia, or anemia) in addition to thrombocytopenia may require bone marrow aspiration/biopsy. [cancertherapyadvisor.com]

Conservative methods of treatment using steroids, dietotherapy, antibiotics or immunosuppressive agents are not particularly effective in treating fistulas. [ncbi.nlm.nih.gov]

Prognosis • Severe bleeding is rare ( 20. [slideshare.net]

Immune thrombocytopenia (ITP) in adults: Initial treatment and prognosis. https://www.uptodate.com/contents/search. Accessed March 13, 2019. George JN, et al. [mayoclinic.org]

Although there is no known cause of ITP and there is no cure, the prognosis for a child with ITP is very good. Usually, the body stops making the antibodies that are attacking the platelets and the disorder resolves on its own. [chop.edu]

Therefore, patients suffering from B-CLL in association with ITP should have a personalized treatment program. 87 Any association of NHL and ITP which changes the prognosis of the patients should be studied carefully. [haematologica.org]

Secondary idiopathic thrombocytopenic purpura Secondary ITP due to other autoimmune or viral processes has a prognosis directly related to the underlying disorder. [cancertherapyadvisor.com]

A greater understanding of the pathogenesis and treatment options can only be definitively clarified by analyses of settings such as the present case, as autoimmune thrombocytopenia is uncommon in patients with malignant lymphoma and the etiology and [ncbi.nlm.nih.gov]

Common Etiologies of Thrombocytopenia with Clinical Findings and Suggested Treatment Etiology Severity Clinical presentation Evaluation Treatment Comments Bone marrow suppression by irradiation, chemotherapy, or neoplasia Moderate to severe History of [aafp.org]

In addition to the platelet count, other values included in the CBC can help point to underlying etiology. [cancertherapyadvisor.com]

Loftus EV, Sandborn WJ (2002) Epidemiology of inflammatory bowel disease. Gastroenterol Clin N Am 31: 1 – 20. ]. [peertechz.com]

Epidemiology of incident immune thrombocytopenia: a nationwide population-based study in France. Blood. 2014 Nov 20. 124(22):3308-15. [Medline]. Danese MD, Lindquist K, Gleeson M, Deuson R, Mikhael J. [emedicine.medscape.com]

In fact, the decision to define as ITP a platelet count between 100 × 10 9 /l and 150 × 10 9 /l in an otherwise healthy individual is not supported by recent epidemiological studies. [journals.plos.org]

"Epidemiology of immune thrombocytopenic purpura in the General Practice Research Database". Br. J. Haematol. 145 (2): 235–44. doi : 10.1111/j.1365-2141.2009.07615.x. PMID 19245432. ^ a b Roback et al. AABB Technical Manual, 16th Ed. [en.wikipedia.org]

EDTA-dependent pseudothrombocytopaenia: a 12-month epidemiological study. Scand J Clin Lab Invest. 1988;48(6):537–542. 18. Sane DC, Damaraju LV, Topol EJ, et al. [aafp.org]

This book provides a concise yet comprehensive summary of the current state of knowledge concerning the pathophysiology, differential diagnosis and treatment options that support day-to-day patient management. [books.google.com]

HCV-associated thrombocytopenia may be considered complex and multifactorial in origin, since different mechanisms have been implicated in its pathophysiology. [ncbi.nlm.nih.gov]

ITP (Pathophysiology)(cont.) skperdon.hubpages.com 1/25/2015 Idiopathic Thrombocytopenic Purpura Prof.Dr. Saad S Al Ani Khorfakkan Hospital 7 8. [slideshare.net]

The National Heart, Lung, and Blood Institute (NHLBI) leads or sponsors many studies aimed at preventing, diagnosing, and treating heart, lung, blood, and sleep disorders. [nhlbi.nih.gov]

Bleeding can be prevented if the platelet count can be kept above 10,000 microL. [ncbi.nlm.nih.gov]

IVIG may be administered to the mother during the pregnancy or platelet transfusion may be given to the developing fetus to prevent severe bleeding. Cesarean section is recommended for delivery to prevent bleeding. Thanks for your feedback! [verywell.com]

The enlarged spleen traps platelets and prevent them from circulating in the bloodstream. [my.clevelandclinic.org]