Ulcerative Colitis and Acute Thrombocytopenia in a Pediatric Patient: A Case Report and Review of the Literature

Abstract

We report the case of a 14-year-old boy affected by ulcerative colitis (UC) and acute thrombocytopenic purpura (ITP) with simultaneous onset. UC diagnosis was based on symptoms, endoscopy and histology findings. ITP diagnosis was based on the normal bone marrow megakaryocyte count, the presence of platelet associated IgG and the absence of splenomegaly. Medical treatments including high doses of steroids, intravenous immunoglobulins were ineffective on ITP course, while UC course was mild for several months after the onset. When colonic inflammation became untractable not responsive at steroids and immunosuppressive agents, colectomy resolved both pathologies.

Resolved Hypereosinophilic Syndrome and Immune Thrombocytopenic Purpura in Ulcerative Colitis Patients Post Colectomy: A Case Series and Literature Review

“…Ten of the cases reviewed by Chandra et al 33 were also refractory to medical therapy and responded only to colectomy. This was also the case in a young boy with UC comorbid with refractory ITP, reported by Papadatou et al 39 who failed on a high dose of steroids and IVIG and responded only to colectomy. Colectomy was also required in two cases reported by Dehal et al 38 and Kwon et al 36 Similarly to adults, colectomy was https://doi.org/10.2147/JIR.S365094…”

“…In this article, we presented two cases of two comorbidities (HES and ITP) occurring in the context of chronic active UC and responding only to surgical colectomy. Though several cases of HES 18,[25][26][27][28] and ITP 14,23,[29][30][31][32][33][34][35][36][37][38][39] have been reported to co-occur with UC, the patients described in this article are unique in their presentation and treatment response. To the best of our knowledge, they represent rare cases of refractory comorbidities in the context of UC that failed conventional medical therapy and responded only to surgical treatment.…”

“…Concomitant occurrence of ITP and UC is rare. 14,23,[29][30][31][32][33][34][35][36][37][38][39] In patients with UC, ITP represents an extraintestinal manifestation of the disease mediated by immune-mediated mechanisms. 29 The differential diagnosis of thrombocytopenia is broad.…”