Suspected immune thrombocytopenia associated with Crohn’s disease

Czech version

Authors: L. Reková ¹; M. Bohoněk ²; T. Tyll ¹
Authors‘ workplace: Klinika anesteziologie, resuscitace a intenzivní medicíny 1. lékařské fakulty Univerzity Karlovy, a Ústřední vojenské nemocnice – Vojenské fakultní nemocnice Praha ¹; Oddělení hematologie a krevní transfuze Ústřední vojenské nemocnice – Vojenské fakultní nemocnice Praha ²
Published in: Anest. intenziv. Med., 31, 2020, č. 4, s. 184-187
Category: Case Reports

Overview

The differential diagnosis of thrombocytopenia of critically ill patients with sepsis is often complicated and time-consuming. Apart from septic thrombocytopenia we have to consider also the immune thrombocytopenia. Immune thrombocytopenia may occur as a complication of servere acute infection especially in case of preexisting autoimmune or systemic disease. The leading symptoms are the decrease of platelet count and possible various haemorrhagic symptoms. In the acute phase the immunosuppressive therapy is indicated (corticosteroids) together with the complex intensive care treatment. We present a case report of suspect immune thrombocytopenia associated with Crohn’s disease.

Keywords:

immune thrombocytopenia – Crohn’s disease – immunosuppressive therapy

Sources

1. Kozák T, Čermák J, Červinek L, Hluší A, Konířová E, Košťál M, et al. Doporučení ČHS pro diagnostiku a léčbu imunitní trombocytopénie (ITP). Transfuze Hematol. Dnes 2017; 23(3): 158–169.

2. Matzdorff A, Meyer O, Ostermann H, Kiefel V, Eberl W, Kühne T, et al. Immune Thrombocytopenia – Current Diagnostics and Therapy: Recommendations of a Joint Working Group of DGHO, ÖGHO, SGH, GPOH and DGTI. Oncol Res Treat 2018; 41(suppl 5): 1–30.

3. Salaj P. Trombocytopenické purpury. Vnitř Lék 2005; 91(7 a 8): 854–860.

4. Izak M, Bussel JB. Management of trombocytopenia. F1000Prime Rep. 2014; 6: 45.

5. Sulovská L, Stejskalová I, Flögelová H, Hrachovinová I, Pospíšilová D. Když trombocytopenie není imunitní trombocytopenická purpura. Pediatr. prax, 2013; 14(6): 257–259.

6. Boyne M, Dye K. Crohn’s colitis and idiopathic thrombocytopenic purpura. Postgrad Med J 2000; 76: 299–306.

7. Shizuma T. Concomitant Imune Thrombocytopenic Purpura and Crohn’s Disease. J Blood Disord Transfus 2015; 6: 295.

8. Snook JA, De Silva HJ, Jewell DP. The association of autoimmune disorders with inflamantory bowel disease. QJ Med 1989; 91: 1232–1235.

9. Baudard M, Molina T, Benfiguig K, Bethoux JP, Zittoun R. Idiopathic thrombocytopenic purpura associated with Crohn’s disease. Hematologica, Scientific letters 1998; 83(1): 92–93.

10. Strauss R, Wehler M, Mehler K, Kreutzer D, Koebnick C, Hahn EG. Trombocytopenia in patients in the medical intensive care unit: Bleeding prevalence, transfusion requirements and outcome. Crit Care Med. 2002 Aug; 30(8): 1765–1771.

11. Venkata Ch, Kashyap R, Farmer JCh, Bekele A. Thrombocytopenia in adult patients with sepsis: incidence, risk factors, and its association with clinical outcome. J Intensive Care 2013; 1(1): 9.

12. Varnon‑Boundes F, Ruiz S, Gratacap M‑P, Garcia C, Payrastre B, Minville V. Platelets are critical key players in sepsis. Int. J. Mol. Sci. 2019; 20(14): 3494.