A Case of Idiopathic Thrombocytopenic Purpura Associated with Basedow's Disease

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  • YOSHIZAWA Kaname
    Department of Internal Medicine, Shinshu University School of Medicine
  • SUZUKI Yoichi
    Department of Internal Medicine, Shinshu University School of Medicine
  • IMAI Toshisuke
    Department of Internal Medicine, Shinshu University School of Medicine
  • SAITO Hiroshi
    Department of Internal Medicine, Shinshu University School of Medicine
  • FURUTA Seiichi
    Department of Internal Medicine, Shinshu University School of Medicine

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Other Title
  • バセドウ病と特発性血小板減少性紫斑病の合併した1例
  • バセドウビョウ ト トクハツセイ ケッショウバン ゲンショウセイ シハンビョウ

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Abstract

A 31-year-old female was referred to our hospital on March 19, 1980, because of purpura and hypermenorrhea over one year with no response to prednisolone therapy. Her past history was noncontributory. Physical findings on admission; scattered petechiae were observed on the upper and lower extremities and the neck. She had a diffuse goiter and an exophthalmus, but no hepatosplenomegaly. Laboratory examination revealed a marked thrombocytopenia (10,000/mm3) with normal red cell and leukocyte counts in peripheral blood. Bone marrow aspiration was unremarkable with normal megakaryocyte count (50/mm3). Serum levels of T4 (13.4μg/dl) and T3 (2.17ng/ml) were both elevated and that of TSH (less than 0.3μIU/ml) depressed. TRH test was unresponsive. Serologically, anti-platelet antibody was negative, thyroid test (×802) and microsome test (×1602) were both positive.<br>On the diagnosis of ITP associated with Basedow's disease, combination therapy of prednisolone and methimazole was instituted with a rapid increase of platelet count to normal. When she became euthyroid, prednisolone therapy was tapered off. The platelet count was sustained normal.<br>The mechanism of the co-occurrence of ITP and Basedow's disease was discussed.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 23 (2), 185-192, 1982

    The Japanese Society of Hematology

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