Published online Jul 7, 2014. doi: 10.3748/wjg.v20.i25.8304
Revised: February 9, 2014
Accepted: March 19, 2014
Published online: July 7, 2014
A variety of clinical manifestations are associated directly or indirectly with tuberculosis. Among them, haematological abnormalities can be found in both the pulmonary and extrapulmonary forms of the disease. We report a case of immune thrombocytopenic purpura (ITP) associated with intestinal tuberculosis in a liver transplant recipient. The initial management of thrombocytopenia, with steroids and intravenous immunoglobulin, was not successful, and the lack of tuberculosis symptoms hampered a proper diagnostic evaluation. After the diagnosis of intestinal tuberculosis and the initiation of specific treatment, a progressive increase in the platelet count was observed. The mechanism of ITP associated with tuberculosis has not yet been well elucidated, but this condition should be considered in cases of ITP that are unresponsive to steroids and intravenous immunoglobulin, especially in immunocompromised patients and those from endemic areas.
Core tip: This is the report of a rare case of immune thrombocytopenic purpura (ITP) associated with intestinal tuberculosis. In approximately 50% of ITP cases, the aetiology is not identifiable. The most common secondary causes are systemic lupus erythematosus, lymphoproliferative diseases, HIV infection and drugs. It is difficult to make a diagnosis of tuberculosis-related ITP, and timely therapy is important. This association should be considered in cases of ITP that are unresponsive to steroids and intravenous immunoglobulin, especially in immunocompromised patients and those from endemic areas.