Korean J Gastrointest Endosc.  2002 Jan;24(1):44-48.

Immune Thrombocytopenic Purpura in a Patient with Preexisting Ulcerative Colitis: A Case Report

• Park BH
• Kim HJ
• Chang YW
• Min SK
• Choi CW
• Lee DK
• Dong SH
• Kim BH
• Lee JI
• Chang R

Abstract

Ulcerative colitis (UC) is a chronic inflammatory bowel disease with evidence of immune activation and is associated with extraintestinal diseases in numerous target tissues. Extraintestinal manifestations of UC are well described in numerous tissues, most notably mucotaneous, synovial, biliary, and opthalmic. Among hematological complications of UC, autoimmune hemolytic anemia is often reported, but immune-mediated thrombocytopenia (ITP) is rare. We present one case in which exacerbation of UC sequentially induced development of ITP. Platelet-associated antibodies were positive. Bone marrow examinations revealed increased megakaryocyte number. ITP was treated with corticosteroids, intravenous immune gamma- globulin and plasmapheresis. However, because previous treatments were not successful, splenectomy was done. This may provide further evidence that ITP is causally associated with UC, and is the result of immunostimulation from luminal antigens and altered immunoregulation.

Keyword

Ulcerative colitis; Immune thrombocytopenic purpura

MeSH Terms

Adrenal Cortex Hormones
Anemia, Hemolytic, Autoimmune
Antibodies
Bone Marrow Examination
Colitis, Ulcerative*
Humans
Immunization
Inflammatory Bowel Diseases
Megakaryocytes
Phenobarbital
Plasmapheresis
Purpura, Thrombocytopenic, Idiopathic*
Splenectomy
Thrombocytopenia
Ulcer*
Adrenal Cortex Hormones
Antibodies
Phenobarbital