Immune Thrombocytopenic Purpura Associated with Pulmonary Tuberculosis

Overview

Journal J Glob Infect Dis

Date 2012 Oct 12

PMID 23055649

Citations 4

Authors

Tapan Das Bairagya

Sibes Kumar Das

Pulak Kumar Jana

Somnath Bhattacharya

Affiliations

Soon will be listed here.

Abstract

Thrombocytopenic purpura as a manifestation of pulmonary tuberculosis is very rare. We report a case of 25-year-old female who presented with thrombocytopenia-induced purpuric spots and an abnormal chest X-ray. There was no hepatosplenomegaly while the bone marrow examination revealed normal maturation of myeloid and erythroid series with increased megakaryocytes. Acid fast bacilli were seen in the sputum microscopy. A diagnosis of sputum smear positive pulmonary tuberculosis along with immune thrombocytopenia was made. High dose intravenous immunoglobulin therapy along with antituberculous drugs corrected the thrombocytopenia and also cured pulmonary tuberculosis. This case report illustrates the causal association between immune thrombocytopenia and tuberculosis.

Citing Articles

Is It a Coincidence or Secondary Immune Thrombocytopenic Purpura? A Case of an 11-Year-Old Male Patient at Hawassa University Comprehensive Specialized Hospital, Hawassa, Sidama, Ethiopia.

Ketema W, Taye K, Tagesse N, Eifa A Int Med Case Rep J. 2022; 15:85-90.

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The dilemma in a case of immune thrombocytopenia in a patient with human immunodeficiency virus on antituberculosis treatment for miliary pulmonary tuberculosis.

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Hematological Abnormalities of Pulmonary Tuberculosis Patients with and without HIV at the University of Gondar Hospital, Northwest Ethiopia: A Comparative Cross-Sectional Study.

Abay F, Yalew A, Shibabaw A, Enawgaw B Tuberc Res Treat. 2019; 2018:5740951.

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Thrombocytopenia in HIV patients coinfected with tuberculosis.

Sandhya A, Prajapat B J Family Med Prim Care. 2018; 6(4):859-861.

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References

Toscano V, Bontadini A, Falsone G, Conte R, Fois F, Fabiani A . Thrombotic thrombocytopenic purpura associated with primary tuberculosis. Infection. 1995; 23(1):58-9. DOI: 10.1007/BF01710061. View

George J, Woolf S, Raskob G, Wasser J, Aledort L, Ballem P . Idiopathic thrombocytopenic purpura: a practice guideline developed by explicit methods for the American Society of Hematology. Blood. 1996; 88(1):3-40. View

Glasser R, Walker R, HERION J . The significance of hematologic abnormalities in patients with tuberculosis. Arch Intern Med. 1970; 125(4):691-5. View

Ghobrial M, Albornoz M . Immune thrombocytopenia: a rare presenting manifestation of tuberculosis. Am J Hematol. 2001; 67(2):139-43. DOI: 10.1002/ajh.1093. View

Rosenberg M, Rumans L . Survival of a patient with pancytopenia and disseminated coagulation associated with miliary tuberculosis. Chest. 1978; 73(4):536-9. DOI: 10.1378/chest.73.4.536. View

Maartens G, Willcox P, Benatar S . Miliary tuberculosis: rapid diagnosis, hematologic abnormalities, and outcome in 109 treated adults. Am J Med. 1990; 89(3):291-6. DOI: 10.1016/0002-9343(90)90340-j. View

Yasuda Y, Matsubara Y, Watanabe S, Hatakenaka R, Funatsu T, Ikeda S . [A case of intractable pulmonary tuberculosis complicated by idiopathic thrombocytopenic purpura (ITP)]. Nihon Kyobu Geka Gakkai Zasshi. 1994; 42(12):2301-5. View

Talbot S, Dowling A, Dowling J, Fuller A, Schwarz M . Mediastinal nodal tuberculosis presenting as immune thrombocytopenia. Aust N Z J Med. 1998; 28(4):465-6. DOI: 10.1111/j.1445-5994.1998.tb02084.x. View

Browett P, Varcoe A, Fraser A, Ellis-Pegler R . Disseminated tuberculosis complicated by the hemophagocytic syndrome. Aust N Z J Med. 1988; 18(1):79-80. DOI: 10.1111/j.1445-5994.1988.tb02250.x. View

10.

Boots R, Roberts A, McEvoy D . Immune thrombocytopenia complicating pulmonary tuberculosis: case report and investigation of mechanisms. Thorax. 1992; 47(5):396-7. PMC: 463768. DOI: 10.1136/thx.47.5.396. View

11.

Bakhshi S, Kabra M, Iyer V, Arya L . Thrombocytopenic purpura as a presenting manifestation of tubercular lymphadenitis. Indian J Pediatr. 2004; 70(12):993-4. DOI: 10.1007/BF02723827. View

12.

Nilsson B, SULTZER B, Bullock W . Purified protein derivative of tuberculin induces immunoglobulin production in normal mouse spleen cells. J Exp Med. 1973; 137(1):127-39. PMC: 2139361. DOI: 10.1084/jem.137.1.127. View

13.

Jurak S, Aster R, Sawaf H . Immune thrombocytopenia associated with tuberculosis. Clin Pediatr (Phila). 1983; 22(4):318-9. DOI: 10.1177/000992288302200416. View