Púrpura trombocitopénica inmune asociada a enfermedad de Crohn con respuesta completa a infliximab

Brunet, E; Sola, Montserrat Martínez de; García-Iglesias, Pilar; Calvet, Xavier

doi:10.1016/j.gastrohep.2018.01.011

Cited by 4 publications

(3 citation statements)

References 8 publications

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“…However, due to the lack of sufficient data, there is no formalized consensus recommendation on the use of immunosuppressants for treatment. In the association of ITP and IBD, the patient can be treated with biological therapy (rituximab and infliximab) and immunosuppressants (azathioprine), with a good response after colectomy as described in some case reports, especially in refractory patients for clinical treatment [4,11,12]. Rituximab is another treatment option for both entities, but the results are not conclusive, highlighting the need for further research to investigate the role of B cell lines in colonic inflammation [13].…”

Section: Discussionmentioning

confidence: 99%

Immune Thrombocytopenic Purpura as an Extraintestinal Manifestation in a Patient with Ulcerative Colitis

Dutra¹,

Almeida²,

Sinkos³

et al. 2022

Case Rep Gastroenterol

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Immune thrombocytopenic purpura (ITP) is characterized by the presence of autoantibodies against platelet membrane antigens, leading to immune-mediated platelet destruction. ITP is considered as a rare extraintestinal manifestation (EIM) of ulcerative colitis (UC). This report aimed to describe a rare case of UC associated with ITP and a review of the literature. A 49-year-old man was admitted to our hospital with severe acute colitis which was responsive to treatment (hydrocortisone 300 mg/day). The patient was discharged from the hospital with prednisone 60 mg/day and azathioprine 50 mg/day. During the follow-up, the dose of azathioprine was increased to 100 mg/day (1.3 mg/kg), while prednisone tapering was started. After 3 months, the patient presented with thrombocytopenia (30,000 platelets/µL) without improvement despite receiving the suspension of azathioprine; thus, a bone marrow aspirate was performed. The bone marrow analysis showed hyperplasia of the erythroid series, megaloblastosis, hyperplasia of megakaryocytes with mild dyspoiesis, and absence of cytotoxicity, a morphological finding consistent with ITP. The patient was treated with prednisone 1 mg/kg/day which resulted in partial improvement of the condition and his still being followed up as outpatient using mesalazine 3.2 g for UC and a platelet count of approximately 50,000/µL using eltrombopag. As reported, ITP is a rare EIM in patients with UC. Due to the risk of complications, such as bleeding, hematological changes in these patients should be considered. The disease should be suspected in the presence of thrombocytopenia, always excluding the side effects of medications in advance, especially immunosuppressants. The correct diagnosis of this rare manifestation and proper treatment are essential to control the condition, prevent complications, and improve the patient’s prognosis.

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Section: Discussionmentioning

confidence: 99%

Immune Thrombocytopenic Purpura as an Extraintestinal Manifestation in a Patient with Ulcerative Colitis

Dutra¹,

Almeida²,

Sinkos³

et al. 2022

Case Rep Gastroenterol

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“…IBDs represent a spectrum of enteropathies, including CD, UC, and IBDU, with a variable level of seriousness and a wide range of associated autoimmune disorders whose cumulative prevalence is 8.2% to 10.5% [ 18 ]. Autoimmune antibody-related hematologic diseases, such as autoimmune hemolytic anemia, autoimmune neutropenia, and ITP [ 5 , 6 , 19 , 20 , 21 ], have been occasionally reported in patients with IBD: up to now, fewer than 80 cases of IBD/ITP association of every age have been published, about two-thirds being UC [ 1 , 7 , 8 ]. There is a scarcity of literature about the association between IBD and ITP in childhood and, other than the cohort of 8 patients of Higuchi [ 12 ], to the best of our knowledge, only 15 other IBD/ITP pediatric patients have been published, mostly in single case reports [ 9 , 10 , 11 , 18 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…Many extraintestinal autoimmune manifestations are reported in inflammatory bowel disease (IBD), the most common hematological type being autoimmune hemolytic anemia [ 1 , 2 , 3 , 4 ]. In rare cases, immune thrombocytopenia (ITP), a hematological disorder characterized by the production of autoantibodies against platelets, can be associated [ 5 , 6 , 7 , 8 , 9 , 10 , 11 ]: only a few patients are of pediatric age [ 1 , 12 ]. In this retrospective study, we analyzed the largest series of children affected by both ITP and IBD.…”

Section: Introductionmentioning

confidence: 99%

Association of Immune Thrombocytopenia and Inflammatory Bowel Disease in Children

Guarina

Barone²,

Tornesello

et al. 2021

JCM

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Background: The association between inflammatory bowel disease (IBD) and immune thrombocytopenia (ITP) is still uncertain. In this multicenter retrospective study, the coexistence of both diseases was investigated in children diagnosed from 1 January 2000 to 31 December 2019. Methods: Clinical characteristics of both IBD and ITP, onset of disorders, and patient’s response to treatment were collected through a structured form sent to 55 Italian pediatric referring centers for hematological disorders. Result: Centers responded to the survey and reported the coexistence of IBD and ITP in 14 children. The first diagnosis was ITP in 57.1% and IBD in 35.7% of patients: it was simultaneous in 7.1%. IBD was classified as ulcerative colitis (57.1%), Crohn disease (35.7%), and unclassified (7.1%). No therapy for IBD other than steroids had any effect on ITP course. Colectomy resulted in recovery from ITP in 1 of the 2 patients surgically treated. ITP was always mild but turned to be chronic in half of patients. Conclusions: In all patients, ITP was mild without any evident impact on IBD severity, but the incidence of chronic ITP seems to be higher than what is usually observed in the pediatric age group. Colectomy had unpredictable effects on ITP.

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Immune thrombocytopenic purpura associated with inactive ulcerative colitis in chronic treatment with adalimumab

Jiménez

García

Martínez

et al. 2020

Gastroenterología y Hepatología (English Edition)

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Púrpura trombocitopénica inmune asociada a enfermedad de Crohn con respuesta completa a infliximab

Cited by 4 publications

References 8 publications

Immune Thrombocytopenic Purpura as an Extraintestinal Manifestation in a Patient with Ulcerative Colitis

Immune Thrombocytopenic Purpura as an Extraintestinal Manifestation in a Patient with Ulcerative Colitis

Association of Immune Thrombocytopenia and Inflammatory Bowel Disease in Children

Immune thrombocytopenic purpura associated with inactive ulcerative colitis in chronic treatment with adalimumab

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