Immune Thrombocytopenic Purpura (ITP) as an Uncommon Extraintestinal Complication of Crohn’s Disease: Case Vignette and Systematic Literature Review
While the association of immune thrombocytopenic purpura (ITP) and inflammatory bowel disease (IBD) has been described in a few case reports, management of ITP as an extraintestinal manifestation of Crohn’s disease (CD) is less studied. There are approximately a dozen cases describing the management...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-01-01
|
| Series: | Case Reports in Hematology |
| Online Access: | http://dx.doi.org/10.1155/2020/4785759 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832566138492420096 |
|---|---|
| author | Raisa Epistola Tiffanie Do Ritika Vankina Daniel Wu James Yeh Michael W. Fleischman Jennifer M. Lee |
| author_facet | Raisa Epistola Tiffanie Do Ritika Vankina Daniel Wu James Yeh Michael W. Fleischman Jennifer M. Lee |
| author_sort | Raisa Epistola |
| collection | DOAJ |
| description | While the association of immune thrombocytopenic purpura (ITP) and inflammatory bowel disease (IBD) has been described in a few case reports, management of ITP as an extraintestinal manifestation of Crohn’s disease (CD) is less studied. There are approximately a dozen cases describing the management of patients dually diagnosed with CD/ITP. Previous reports postulated that the mechanism of ITP in CD was through the presence of circulating immune complexes in the serum and antigenic mimicry due to increased mucosal permeability in active colitis, versus increased mucosal production of TH1-type proinflammatory cytokines during CD flares, which may account for remission of ITP with surgery for CD. We present a case of a 27-year-old man who presented with medically refractory CD and ITP who responded to surgical management with colectomy and splenectomy, along with a systematic review of the literature. These cases suggest that colectomy should be considered in the treatment of medically refractory ITP among patients with concomitant CD. |
| format | Article |
| id | doaj-art-6fcaf94ece2141f6b07d84e003b138ee |
| institution | Kabale University |
| issn | 2090-6560 2090-6579 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Hematology |
| spelling | doaj-art-6fcaf94ece2141f6b07d84e003b138ee2025-02-03T01:04:59ZengWileyCase Reports in Hematology2090-65602090-65792020-01-01202010.1155/2020/47857594785759Immune Thrombocytopenic Purpura (ITP) as an Uncommon Extraintestinal Complication of Crohn’s Disease: Case Vignette and Systematic Literature ReviewRaisa Epistola0Tiffanie Do1Ritika Vankina2Daniel Wu3James Yeh4Michael W. Fleischman5Jennifer M. Lee6Harbor-UCLA Medical Center, Department of Medicine, Torrance, CA, USAHarbor-UCLA Medical Center, Department of Medicine, Torrance, CA, USAHarbor-UCLA Medical Center, Department of Medicine, Division of Hematology & Medical Oncology, Torrance, CA, USAHarbor-UCLA Medical Center, Department of Medicine, Division of Hematology & Medical Oncology, Torrance, CA, USAHarbor-UCLA Medical Center, Department of Medicine, Division of Hematology & Medical Oncology, Torrance, CA, USAHarbor-UCLA Medical Center, Department of Medicine, Division of Gastroenterology, Torrance, CA, USAHarbor-UCLA Medical Center, Department of Medicine, Division of Hematology & Medical Oncology, Torrance, CA, USAWhile the association of immune thrombocytopenic purpura (ITP) and inflammatory bowel disease (IBD) has been described in a few case reports, management of ITP as an extraintestinal manifestation of Crohn’s disease (CD) is less studied. There are approximately a dozen cases describing the management of patients dually diagnosed with CD/ITP. Previous reports postulated that the mechanism of ITP in CD was through the presence of circulating immune complexes in the serum and antigenic mimicry due to increased mucosal permeability in active colitis, versus increased mucosal production of TH1-type proinflammatory cytokines during CD flares, which may account for remission of ITP with surgery for CD. We present a case of a 27-year-old man who presented with medically refractory CD and ITP who responded to surgical management with colectomy and splenectomy, along with a systematic review of the literature. These cases suggest that colectomy should be considered in the treatment of medically refractory ITP among patients with concomitant CD.http://dx.doi.org/10.1155/2020/4785759 |
| spellingShingle | Raisa Epistola Tiffanie Do Ritika Vankina Daniel Wu James Yeh Michael W. Fleischman Jennifer M. Lee Immune Thrombocytopenic Purpura (ITP) as an Uncommon Extraintestinal Complication of Crohn’s Disease: Case Vignette and Systematic Literature Review Case Reports in Hematology |
| title | Immune Thrombocytopenic Purpura (ITP) as an Uncommon Extraintestinal Complication of Crohn’s Disease: Case Vignette and Systematic Literature Review |
| title_full | Immune Thrombocytopenic Purpura (ITP) as an Uncommon Extraintestinal Complication of Crohn’s Disease: Case Vignette and Systematic Literature Review |
| title_fullStr | Immune Thrombocytopenic Purpura (ITP) as an Uncommon Extraintestinal Complication of Crohn’s Disease: Case Vignette and Systematic Literature Review |
| title_full_unstemmed | Immune Thrombocytopenic Purpura (ITP) as an Uncommon Extraintestinal Complication of Crohn’s Disease: Case Vignette and Systematic Literature Review |
| title_short | Immune Thrombocytopenic Purpura (ITP) as an Uncommon Extraintestinal Complication of Crohn’s Disease: Case Vignette and Systematic Literature Review |
| title_sort | immune thrombocytopenic purpura itp as an uncommon extraintestinal complication of crohn s disease case vignette and systematic literature review |
| url | http://dx.doi.org/10.1155/2020/4785759 |
| work_keys_str_mv | AT raisaepistola immunethrombocytopenicpurpuraitpasanuncommonextraintestinalcomplicationofcrohnsdiseasecasevignetteandsystematicliteraturereview AT tiffaniedo immunethrombocytopenicpurpuraitpasanuncommonextraintestinalcomplicationofcrohnsdiseasecasevignetteandsystematicliteraturereview AT ritikavankina immunethrombocytopenicpurpuraitpasanuncommonextraintestinalcomplicationofcrohnsdiseasecasevignetteandsystematicliteraturereview AT danielwu immunethrombocytopenicpurpuraitpasanuncommonextraintestinalcomplicationofcrohnsdiseasecasevignetteandsystematicliteraturereview AT jamesyeh immunethrombocytopenicpurpuraitpasanuncommonextraintestinalcomplicationofcrohnsdiseasecasevignetteandsystematicliteraturereview AT michaelwfleischman immunethrombocytopenicpurpuraitpasanuncommonextraintestinalcomplicationofcrohnsdiseasecasevignetteandsystematicliteraturereview AT jennifermlee immunethrombocytopenicpurpuraitpasanuncommonextraintestinalcomplicationofcrohnsdiseasecasevignetteandsystematicliteraturereview |